Active NPI
Justin Michael Croft, PA-C
- Physician Assistant
- Aiken, SC
National Provider Identifier
1770835522
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA1895
- Practice address
- 934 Dougherty Rd
Aiken, SC 29803-6515 - Phone
- (036) 430-0588
- Fax
- (803) 643-1776
- NPI assigned
- Oct 3, 2012
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgical Physician Assistant | 363AS0400X | 008321 | GA | |
| Physician Assistant | 363A00000X | PA1895 | SC | Primary |
Addresses
Primary practice location
934 Dougherty Rd
Aiken, SC 29803-6515
Mailing address
PO Box 1705
Augusta, GA 30903-1705
Phone (706) 774-7263
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1647PA | Medicaid | SC |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | justin-croft@univmedassocofaiken.e-mdsdirect.com | Direct |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in SC
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20130726000481 | SC | Practitioner - Physician Assistant | 6901057454 | Reassigns benefits to 2 organizations |
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2012
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
118 Park Ave SW
Aiken, SC 29801-3835
Phone (706) 721-8623
934 Dougherty Rd
Aiken, SC 29803-6515
Phone (803) 643-0588
Hospital & facility affiliations
- Centerwell Home Health
- Wellstar MCG Health, Affiliated With Med Col
- Aiken Regional Medical Center
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1895 | SC | MD | Psychologist |
| PA1895 | SC | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Wellstar Medical Group, LLC | Current | Accepting new patients | |
| Wellstar Cardiovascular Medicine, LLC | Past | Accepting new patients |
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.
-
- Cardiovascular Disease Physician
- Marietta, GA
- NPI 1457320319
Hospital & facility affiliations 5
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Neurological Surgery Physician
- Aiken, SC
- NPI 1942610928
Hospital
-
- Home Health Agency
- Newberry, SC
- NPI 1760857767
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1349222400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1608508800000",
"number": "1770835522",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1705",
"city": "AUGUSTA",
"state": "GA",
"postal_code": "309031705",
"telephone_number": "706-774-7263",
"fax_number": "706-774-7230"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "934 DOUGHERTY RD",
"city": "AIKEN",
"state": "SC",
"postal_code": "298036515",
"telephone_number": "036-430-0588",
"fax_number": "803-643-1776"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CROFT",
"first_name": "JUSTIN",
"middle_name": "MICHAEL",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-10-03",
"last_updated": "2020-12-21",
"certification_date": "2020-12-21",
"status": "A"
},
"taxonomies": [
{
"code": "363AS0400X",
"taxonomy_group": "",
"desc": "Physician Assistant, Surgical",
"state": "GA",
"license": "008321",
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "SC",
"license": "PA1895",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1647PA",
"state": "SC"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "justin-croft@univmedassocofaiken.e-mdsdirect.com",
"affiliation": "N",
"endpointDescription": "Direct Message via EHR",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "Direct Message",
"address_1": "934 Dougherty Rd",
"city": "Aiken",
"state": "SC",
"country_code": "US",
"postal_code": "298036515",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Aiken, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.