NPIMap

Individual provider Active NPI

Maurio Riley

  • Physician Assistant
  • Columbia, SC
National Provider Identifier
1790189678
Registry record updated Sep 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
2211 Issued in SC
Practice address
100 Palmetto Health Pkwy Ste 104
Columbia, SC 29212-1754
Phone
(803) 000-0000
NPI assigned
Oct 21, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 2211 SC Primary

Addresses

Primary practice location

100 Palmetto Health Pkwy Ste 104
Columbia, SC 29212-1754

Mailing address

100 Palmetto Health Pkwy Ste 104
Columbia, SC 29212-1754
Phone (803) 782-4278

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
I20141220000290 SC Practitioner - Physician Assistant 2961725023 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Medical University of South Carolina College of Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Musc Community PhysiciansGroup PAC ID 6507260668, 1,353 clinicians

Practice addresses (Care Compare)

114 Gateway Corp Blvd
Columbia, SC 29203-9785

120 Gateway Corp Blvd
Columbia, SC 29203-9611
Phone (803) 432-4311

506 N St
Bamberg, SC 29003-1319
Phone (803) 245-6290

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
80.41 of 100Reported as group
Quality
64.93
Promoting interoperability
99
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
2211SCMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Musc Community Physicians CurrentSince Aug 1, 2022 Accepting new patients
Musc Community Physicians CurrentSince Aug 1, 2022 Accepting new patients

Locations

506 North St
Bamberg, SC 29003
Phone (803) 245-6290

Interoperability endpoints

  • Direct secure messaging: mriley76177@direct.musc.edu

Organizations & group practices 2

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 12

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": "1413849600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632096000000",
    "number": "1790189678",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 PALMETTO HEALTH PKWY STE 104",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292121754",
            "telephone_number": "803-782-4278"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 PALMETTO HEALTH PKWY STE 104",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292121754",
            "telephone_number": "803-000-0000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RILEY",
        "first_name": "MAURIO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-10-21",
        "last_updated": "2021-09-20",
        "certification_date": "2021-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "SC",
            "license": "2211",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, SC

Sources for this page

Verify at the official NPI Registry.