Elijah Scott Bausum, AGNP-C

Primary specialty

Urology PhysicianTaxonomy code 208800000X

License

28689 Issued in SC

Practice address

1285 Wilson Hall Rd
Sumter, SC 29150-1804

Phone

(803) 905-3555

NPI assigned

Apr 30, 2024

Last updated

Apr 30, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Urology Clinic, Inc.Group PAC ID 2860781556, 4 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• McLeod Regional Medical Center-Pee Dee Hospital, Florence, SC, CCN 420051
• Prisma Health Tuomey Hospital Hospital, Sumter, SC, CCN 420070

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Urology Clinic, Inc.

  • Urology Physician
  • Sumter, SC
  • NPI 1912368457
  Medicare reassignment Care Compare group NPD

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

• McLeod Regional Medical Center of the Pee Dee, Inc.

  • General Acute Care Hospital
  • Florence, SC
  • NPI 1699756221
  Care Compare affiliation
• Prisma Health-Midlands

  dba Prisma Health Tuomey Hosptial

  • General Acute Care Hospital
  • Sumter, SC
  • NPI 1326043548
  Care Compare affiliation

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

{
    "created_epoch": "1714435200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714435200000",
    "number": "1801642707",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "704 HAILE ST",
            "city": "SUMTER",
            "state": "SC",
            "postal_code": "291503144",
            "telephone_number": "803-464-2698"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1285 WILSON HALL RD",
            "city": "SUMTER",
            "state": "SC",
            "postal_code": "291501804",
            "telephone_number": "803-905-3555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAUSUM",
        "first_name": "ELIJAH",
        "middle_name": "SCOTT",
        "credential": "AGNP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-04-30",
        "last_updated": "2024-04-30",
        "certification_date": "2024-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "SC",
            "license": "28689",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eugene Russell Baten, LMSW
• Courtney Bath, PHARM D.
• Batteries Plus of Sumter, LLC
• Anthony Jason Baugh, PA-C
• Emily Holland Baust, OTR/L
• Sherritta T. Beaufort
• Leslie A Beben, PA
• Elizabeth Cullom Beck, ABAT
• Kirsten April Becksvoort, D.O
• Kimberly L Behling-Pinkston, CCC-SLP

• Urology Physician in Sumter, SC
• Providers in Sumter, SC by specialty
• Urology Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2024; 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.

Verify at the official NPI Registry.