Roberta Rae Alsworth, PA-C
Individual provider Active NPI Physician Assistant · Myrtle Beach, SC
NPI 1790775385 · NPPES record last updated Jan 29, 2021
Key facts
- NPI
- 1790775385
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- A362 (SC)
- Practice address
- 945 82ND Pkwy
Suite 3
Myrtle Beach, SC 29572-4610 - Phone
- (843) 449-3381
- Fax
- (843) 839-0275
- NPI assigned
- Oct 25, 2005
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 4
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- Other, 2004
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- McLeod Physician Associates II
Practice addresses (Care Compare)
3112 Casey St
Loris, SC 29569-2808
Phone (843) 716-8940
800 E Cheves St
Florence, SC 29506-2650
800 E Cheves St
Florence, SC 29506-2652
Hospital & facility affiliations
- McLeod Loris Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in SC
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20100609000084 | SC | Practitioner - Physician Assistant | 4082744610 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 362 | SC | MD | School Psychologist |
| A362 | SC | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| McLeod Physician Associates II | Current |
Accepting new patients | |
| McLeod Physician Associates II | Past | Accepting new patients |
Locations
800 E Cheves St
Ste 480A
Florence, SC 29506
Phone (843) 777-7337
800 E Cheves St
Ste 240
Florence, SC 29506
Phone (843) 777-7950
506 E Cheves St
#202
Florence, SC 29506
107 McLeod Health Blvd
Bldg 3
Myrtle Beach, SC 29579
Phone (843) 366-3920
Interoperability endpoints
- ralsworth19268@directmcleodehealth.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | A362 | SC | Yes |
Addresses
Primary practice location
945 82ND Pkwy
Suite 3
Myrtle Beach, SC 29572-4610
Mailing address
506 E Cheves St
Suite 202
Florence, SC 29506-2616
Phone (843) 777-7010
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | roberta.alsworth@mpaii.eclinicaldirectplus.com | Direct |
Other providers in Myrtle Beach, SC
- Fouad S Allouch
- Abdulelah Almutairi
- Olubunmi Ashabi Alo
- Amy Katherine Alsbrooks
- M'Kayla Alston
- Alternative Health Clinic
- Alternative Living Solutions of South Carolina LLC
- Delon Alaine Altherr
- Staci L Alumbaugh
- Michael Alvarado
All providers in Myrtle Beach, SC · Physician Assistant in South Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 29, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.