Individual provider Active NPI

David Pratt Sellman, MD

  • Student in an Organized Health Care Education/Training Program
  • Charleston, SC
National Provider Identifier
1770074825
Registry record updated May 24, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
License
52468 Issued in SC
Practice address
169 Ashley Ave
Charleston, SC 29425-8905
Phone
(843) 792-3072
NPI assigned
May 24, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 24, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X 52468 SC Primary

Addresses

Primary practice location

169 Ashley Ave
Charleston, SC 29425-8905

Mailing address

169 Ashley Avenue
Room 202 Main Hospital Msc333
Charleston, SC 29425
Phone (843) 792-3072

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231003000084 FL Practitioner - Urology 9638589724 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
Medical University of South Carolina College of Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

710 Lomax St
Jacksonville, FL 32204-4015
Phone (904) 355-6583

Hospital & facility affiliations

  • Enhabit Home Health Home health agency, Jacksonville, FL, CCN 108148
  • Baptist Health Medical Center - Jacksonville Hospital, Jacksonville, FL, CCN 100088
  • Ascension St Vincent'S Southside Hospital, Jacksonville, FL, CCN 100307
  • Baptist Medical Center Beaches Hospital, Jacksonville Beach, FL, CCN 100117
  • HCA Florida Memorial Hospital Hospital, Jacksonville, FL, CCN 100179
  • Ascension St Vincent'S Riverside Hospital, Jacksonville, FL, CCN 100040

Procedures performed for Medicare patients

ProcedureNumber of procedures
Prostate resection23
Removal of skin lesions1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
52468SCMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
McIver Urological Clinic Current Accepting new patients
Florida Physician Specialists LLC Current Accepting new patients
Florida Physician Specialists LLC CurrentSince Aug 1, 2023 Accepting new patients

Locations

1860 Town Hall Cir
Fleming Island, FL 32003
Phone (904) 520-6800

3627 University Blvd S
Ste 605
Jacksonville, FL 32216
Phone (904) 658-0176

8774 Perimeter Park Blvd
Jacksonville, FL 32216
Phone (904) 642-6100

14540 Old St Augustine Rd
Ste 2401
Jacksonville, FL 32258
Phone (904) 880-4054

836 Prudential Dr
Ste 1502
Jacksonville, FL 32207
Phone (904) 396-5540

710 Lomax St
Jacksonville, FL 32204
Phone (904) 355-6584

710 Lomax St
Ste L
Jacksonville, FL 32204

710 Lomax St
Ste 1
Jacksonville, FL 32204
Phone (904) 483-2310

1577 Roberts Dr
Ste 326
Jacksonville Beach, FL 32250
Phone (904) 270-2706

1658 St Vincents Way
Ste 220
Middleburg, FL 32068

300 Saint Elizabeth Way
Ste 145
St Johns, FL 32259

Interoperability endpoints

  • Direct secure messaging: davidsellman@miuc.allscriptsdirect.net

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1527120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1527120000000",
    "number": "1770074825",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "169 ASHLEY AVENUE",
            "address_2": "ROOM 202 MAIN HOSPITAL MSC333",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "29425",
            "telephone_number": "843-792-3072"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "169 ASHLEY AVE",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294258905",
            "telephone_number": "843-792-3072"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SELLMAN",
        "first_name": "DAVID",
        "middle_name": "PRATT",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-05-24",
        "last_updated": "2018-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "SC",
            "license": "52468",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, SC

Sources for this page

Verify at the official NPI Registry.