NPIMap

Individual provider Active NPI

Marcus Duane Stanbro, D.O.

  • Phlebology Physician
  • Greenville, SC
National Provider Identifier
1811940224
Registry record updated Nov 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Phlebology PhysicianTaxonomy code 202K00000X
License
662 Issued in SC
Practice address
200 Patewood Dr Ste B260
Greenville, SC 29615-6328
Phone
(864) 454-2852
Fax
(864) 454-2899
NPI assigned
May 18, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 10, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Phlebology Physician 202K00000X 662 SC Primary

Addresses

Primary practice location

200 Patewood Dr Ste B260
Greenville, SC 29615-6328

Mailing address

300 E McBee Ave FL 4
Greenville, SC 29601-2842
Phone (864) 522-8603

Other identifiers 2

IdentifierTypeStateIssuer
T00808MedicaidSC
P00802362OtherSCRR MEDICARE

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mstanbro31173@direct.ghs.myhfn.org Direct

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
I20040708000254 SC Practitioner - Vascular SurgeryPractitioner - Internal Medicine 4789662768 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Vascular SurgeryAlso: Internal Medicine
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

100 Omni Dr
Suite a
Seneca, SC 29672-9448
Phone (864) 885-7520

102 B Omni Dr
Seneca, SC 29672-9448
Phone (864) 885-7971

103 Omni Dr
Suite B
Seneca, SC 29672-9448
Phone (864) 886-9250

105 B Omni Dr
Seneca, SC 29672-9448
Phone (864) 482-3157

107 Omni Dr
Suite a
Seneca, SC 29672-9448
Phone (864) 885-7475

109 Omni Dr
Suite B
Seneca, SC 29672-9448
Phone (864) 888-4222

175 Patewood Dr
Greenville, SC 29615-3570
Phone (864) 797-1403

200 Fleetwood Dr
Easley, SC 29640-2022
Phone (864) 442-7618

200 Patewood Dr
Suite C300
Greenville, SC 29615-6324
Phone (864) 454-8272

210 Freeman Farm Rd
Duncan, SC 29334-9398
Phone (864) 968-5123

22725 Hwy 76 E
Clinton, SC 29325-7527
Phone (864) 833-4545

22725 US Hwy 76
Suite 3C
Clinton, SC 29325-7527
Phone (864) 833-3852

298 Memorial Dr
Seneca, SC 29672-9443
Phone (864) 455-2455

300 E McBee Ave
Greenville, SC 29601-2842
Phone (864) 797-6220

300 E McBee Ave FL
Suite 4
Greenville, SC 29601-2842

830 S Buncombe Rd
Greer, SC 29650-2400
Phone (864) 455-2455

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Varicose vein removal169
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5038OHMDClinical Psychologist
662SCMDWomen's Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Prisma Health University Medical Group CurrentSince Jan 1, 2010 Accepting new patients
Greenville Health System CurrentSince Dec 10, 2001 Accepting new patients
Greenville Health System Current Accepting new patients
Prisma Health University Medical Group Current Accepting new patients

Locations

210 Freeman Farm Rd
Duncan, SC 29334
Phone (864) 968-5123

200 Patewood Dr
Ste C300
Greenville, SC 29615
Phone (864) 454-2852

100 Augusta St
Greenville, SC 29601
Phone (864) 455-2600

2A Cleveland Ct
Greenville, SC 29607
Phone (864) 271-7761

200 Patewood Dr
Ste B260
Greenville, SC 29615
Phone (864) 454-2100

877 W Faris Rd
Ste C
Greenville, SC 29605
Phone (864) 455-8147

1 Independence Pt
Ste 212
Greenville, SC 29615
Phone (864) 797-6306

300 E McBee Ave
Fl 4
Greenville, SC 29601
Phone (864) 522-8615

200 Patewood Dr
Bldg A
Greenville, SC 29615
Phone (864) 454-2604

315 Medical Pkwy
Ste 200
Greer, SC 29650
Phone (864) 797-9550

719A SE Main St
Simpsonville, SC 29681
Phone (864) 967-9000

807 N Main St
Travelers Rst, SC 29690
Phone (864) 834-5132

Organizations & group practices 4

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 20

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

View all 20

NPI Registry JSON

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

{
    "created_epoch": "1147910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668038400000",
    "number": "1811940224",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 E MCBEE AVE FL 4",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296012842",
            "telephone_number": "864-522-8603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 PATEWOOD DR STE B260",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296156328",
            "telephone_number": "864-454-2852",
            "fax_number": "864-454-2899"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STANBRO",
        "first_name": "MARCUS",
        "middle_name": "DUANE",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-18",
        "last_updated": "2022-11-10",
        "certification_date": "2022-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "202K00000X",
            "taxonomy_group": "",
            "desc": "Phlebology",
            "state": "SC",
            "license": "662",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "T00808",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00802362",
            "state": "SC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mstanbro31173@direct.ghs.myhfn.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "mstanbro31173@direct.ghs.myhfn.org",
            "address_1": "200 Patewood Dr",
            "address_2": "Suite C300",
            "city": "Greenville",
            "state": "SC",
            "country_code": "US",
            "postal_code": "296153593",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Greenville, SC

Sources for this page

Verify at the official NPI Registry.