Individual provider Active NPI

Patrick Harley Dennis Jr., M.D.

  • Ophthalmology Physician
  • Charleston, SC
National Provider Identifier
1811976517
Registry record updated Aug 26, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
14612 Issued in SC
Practice address
2097 Henry Tecklenburg Dr Ste 204
Charleston, SC 29414-5739
Phone
(843) 577-2020
Fax
(843) 577-2105
NPI assigned
Jan 11, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 14612 SC Primary

Addresses

Primary practice location

2097 Henry Tecklenburg Dr Ste 204
Charleston, SC 29414-5739

Mailing address

2097 Henry Tecklenburg Dr Ste 204
Charleston, SC 29414-5739
Phone (843) 577-2020

Other identifiers 1

IdentifierTypeStateIssuer
146121MedicaidSC

Medicare participation

Medicare enrollment files
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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040319000717 SC Practitioner - Ophthalmology 0840180030 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
Medical University of South Carolina College of Medicine, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2097 Henry Tecklenburg Dr
Suite 204
Charleston, SC 29414-5739
Phone (843) 577-2020

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
14612SCMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Patrick H. Dennis, Jr.,MD Ophthalmology CurrentSince Aug 7, 1989 Accepting new patients

Locations

116 Ashley Ave
Ste B
Charleston, SC 29401
Phone (843) 577-2020

2097 Henry Tecklenburg Dr
Ste 204
Charleston, SC 29414
Phone (843) 577-2020

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1136937600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566777600000",
    "number": "1811976517",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2097 HENRY TECKLENBURG DR STE 204",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294145739",
            "telephone_number": "843-577-2020",
            "fax_number": "843-577-2105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2097 HENRY TECKLENBURG DR STE 204",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294145739",
            "telephone_number": "843-577-2020",
            "fax_number": "843-577-2105"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DENNIS",
        "first_name": "PATRICK",
        "middle_name": "HARLEY",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-11",
        "last_updated": "2019-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "SC",
            "license": "14612",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "146121",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, SC

Sources for this page

Verify at the official NPI Registry.