NPIMap

Individual provider Active NPI

Deewan Deewan, MD

  • Nephrology Physician
  • Columbia, SC
National Provider Identifier
1811292055
Registry record updated May 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
40554 Issued in SC
Practice address
1655 Bernardin Ave Ste 200
Columbia, SC 29204-2044
Phone
(803) 256-1137
Fax
(803) 256-1138
NPI assigned
Jan 19, 2011
Last updated
May 16, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 16, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 40554 SC
Nephrology Physician 207RN0300X 40554 SC Primary

Addresses

Primary practice location

1655 Bernardin Ave Ste 200
Columbia, SC 29204-2044

Mailing address

1655 Bernardin Ave Ste 200
Columbia, SC 29204-2044
Phone (803) 256-1137

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
I20171227001919 SC Practitioner - Internal Medicine 6406024587 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Carolina Kidney Specialists, LLCGroup PAC ID 2567462575, 5 clinicians

Practice addresses (Care Compare)

1655 Bernardin Ave
Suite 200
Columbia, SC 29204-2044
Phone (803) 256-1137

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
40554SCMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Carolina Kidney Specialists, LLC Nephrology CurrentSince Oct 7, 2017 Accepting new patients

Locations

1655 Bernardin Ave
Ste 200
Columbia, SC 29204
Phone (803) 256-1137

Interoperability endpoints

  • Direct secure messaging: carolinakidneyspecialist.deewandeewan@125427.advancedmd-direct.com
  • Direct secure messaging: ddeewan380142@direct.musc.edu

Organizations & group practices 1

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 18

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

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1295395200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684195200000",
    "number": "1811292055",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1655 BERNARDIN AVE STE 200",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292042044",
            "telephone_number": "803-256-1137",
            "fax_number": "803-256-1138"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1655 BERNARDIN AVE STE 200",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292042044",
            "telephone_number": "803-256-1137",
            "fax_number": "803-256-1138"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEEWAN",
        "first_name": "DEEWAN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-01-19",
        "last_updated": "2023-05-16",
        "certification_date": "2023-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "SC",
            "license": "40554",
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "SC",
            "license": "40554",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, SC

Sources for this page

Verify at the official NPI Registry.