NPIMap

Individual provider Active NPI

Andrew Ernest Hack, MD

  • Ophthalmology Physician
  • Greenville, SC
National Provider Identifier
1770927212
Registry record updated Jan 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
51662 Issued in SC
Practice address
113 Doctors Dr
Greenville, SC 29605-5608
Phone
(864) 269-3333
Fax
(864) 295-1288
NPI assigned
Apr 27, 2013
Last updated
Jan 13, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 32807 OK
Ophthalmology Physician 207W00000X 51662 SC Primary
Cornea and External Diseases Specialist Physician 207WX0120X 51662 SC

Addresses

Primary practice location

113 Doctors Dr
Greenville, SC 29605-5608

Mailing address

113 Doctors Dr
Greenville, SC 29605-5608
Phone (864) 269-3333

Other identifiers 1

IdentifierTypeStateIssuer
516622MedicaidSC

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180716002786 SC Practitioner - Ophthalmology 9335429554 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
University of South Carolina School of Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

113 Doctors Dr
Greenville, SC 29605-5608
Phone 86426933332271

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery290
Removal or shaving of skin growth1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Southern Eye Associates of South Carolina, PA Ophthalmology Current Accepting new patients
Southern Eye Associates of SC, PA Ophthalmology CurrentSince Aug 1, 2018 Accepting new patients
Southern Eye Associates of South Carolina, PA Ophthalmology CurrentSince Aug 1, 2018 Accepting new patients

Locations

161 Thomas Green Blvd
Clemson, SC 29631
Phone (864) 269-3333

113 Doctors Dr
Greenville, SC 29605
Phone (864) 269-3333

100 Physicians Dr
Greer, SC 29650
Phone (864) 269-3333

100 Allawood Ct
Ste 102
Simpsonville, SC 29681

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 45

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

View all 45

NPI Registry JSON

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

{
    "created_epoch": "1367020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610496000000",
    "number": "1770927212",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "113 DOCTORS DR",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296055608",
            "telephone_number": "864-269-3333",
            "fax_number": "864-295-1288"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "113 DOCTORS DR",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296055608",
            "telephone_number": "864-269-3333",
            "fax_number": "864-295-1288"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HACK",
        "first_name": "ANDREW",
        "middle_name": "ERNEST",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-04-27",
        "last_updated": "2021-01-13",
        "certification_date": "2021-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "OK",
            "license": "32807",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "SC",
            "license": "51662",
            "primary": true
        },
        {
            "code": "207WX0120X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Cornea and External Diseases Specialist",
            "state": "SC",
            "license": "51662",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "516622",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, SC

Sources for this page

Verify at the official NPI Registry.