NPIMap

Individual provider Active NPI

Hamid Reza Bahadori, M.D.

  • Neurology Physician
  • Charleston, SC
National Provider Identifier
1861571887
Registry record updated Sep 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
LL24898 Issued in SC
Practice address
3531 Mary Ader Ave Ste a
Charleston, SC 29414-5896
Phone
(843) 723-0202
NPI assigned
Nov 2, 2006
Last updated
Sep 24, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X LL24898 SC Primary

Addresses

Primary practice location

3531 Mary Ader Ave Ste a
Charleston, SC 29414-5896

Mailing address

3531 Mary Ader Ave Ste a
Charleston, SC 29414-5896
Phone (843) 723-0202

Other identifiers 2

IdentifierTypeStateIssuer
LL24898OtherSCMEDICAL LICENSE
GP0011MedicaidSC

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address HamidBahadori@carolinaneurologicalclinic.ssdirect.aprima.com 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
I20070725000596 SC Practitioner - Neurology 4587765219 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Carolina Neurological Clinic, L.L.P.Group PAC ID 7719953942, 2 clinicians

Practice addresses (Care Compare)

3531 Mary Ader Ave
Suite a
Charleston, SC 29414-5896
Phone (843) 723-0202

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
85.61 of 100Reported as group
Quality
71.21
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
LL24898SCMDNeurology Physician
24898SCMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Roper Hospital, Inc. Current Accepting new patients
Roper Hospital Inc. CurrentSince Jan 1, 2016 Accepting new patients
Bon Secours St. Francis Xavier Hospital, Inc. CurrentSince Jan 1, 2016 Accepting new patients
Carolina Neurological Clinic, L.L.P. Neurology CurrentSince Jul 1, 2007 Accepting new patients
Roper Hospital, Inc CurrentSince Jan 1, 2016 Accepting new patients
Bon Secours St Francis Xavier Hospital, Inc. Current Accepting new patients
Bon Secours St. Francis Xavier Hospital, Inc. CurrentSince Jan 1, 2016 Accepting new patients

Locations

125 Doughty St
Ste 460
Charleston, SC 29403
Phone (803) 723-0202

2095 Henry Tecklenburg Dr
Charleston, SC 29414
Phone (843) 402-1037

316 Calhoun St
Charleston, SC 29401
Phone (843) 724-2000

3531 Mary Ader Ave
Ste A
Charleston, SC 29414
Phone (843) 556-1300

416 Robertson Blvd
Ste B
Walterboro, SC 29488
Phone (843) 549-2411

Interoperability endpoints

  • Direct secure messaging: hamidbahadori@carolinaneurologicalclinic.ssdirect.aprima.com

Organizations & group practices 7

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 7

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

NPI Registry JSON

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

{
    "created_epoch": "1162425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600905600000",
    "number": "1861571887",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3531 MARY ADER AVE STE A",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294145896",
            "telephone_number": "843-723-0202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3531 MARY ADER AVE STE A",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294145896",
            "telephone_number": "843-723-0202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAHADORI",
        "first_name": "HAMID",
        "middle_name": "REZA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-02",
        "last_updated": "2020-09-24",
        "certification_date": "2020-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "SC",
            "license": "LL24898",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "LL24898",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP0011",
            "state": "SC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "HamidBahadori@carolinaneurologicalclinic.ssdirect.aprima.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "3531 Mary Ader Ave Ste A",
            "city": "Charleston",
            "state": "SC",
            "country_code": "US",
            "postal_code": "294145896",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Charleston, SC

Sources for this page

Verify at the official NPI Registry.