NPIMap

Individual provider Active NPI

Andrew Gregory Anthony De Nazareth, M.B.B.S.

  • Cardiovascular Disease Physician
  • Alcoa, TN
National Provider Identifier
1861690802
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
MD51636 Issued in TN
Practice address
266 Joule St
Alcoa, TN 37701-2422
Phone
(865) 984-3864
Fax
(865) 380-4095
NPI assigned
Jul 10, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X MD51636 TN Primary

Addresses

Primary practice location

266 Joule St
Alcoa, TN 37701-2422

Mailing address

103 W Broadway Ave
Maryville, TN 37801-4703
Phone (865) 273-1752

Other identifiers 1

IdentifierTypeStateIssuer
Q006909MedicaidTN

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
I20210907000137 SC Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Anesthesiology 3577708635 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bon Secours Medical Group Greenville Specialty Care LLCGroup PAC ID 1850779976, 290 clinicians

Practice addresses (Care Compare)

1 Saint Francis Dr
Greenville, SC 29601-3955
Phone (513) 853-8520

125 Commonwealth Dr
Greenville, SC 29615-4812
Phone (864) 675-4000

2 Innovation Dr
Suite 330
Greenville, SC 29607-5261
Phone (864) 235-7665

2 Innovation Dr
Suite 400
Greenville, SC 29607-5270
Phone (864) 235-7665

212 Frontage Rd
Clemson, SC 29631-1642
Phone (864) 654-5855

317 Saint Francis Dr
Suite 220
Greenville, SC 29601-3976
Phone (864) 255-1901

3970 Grandview Dr
Simpsonville, SC 29680-3163

702 N a St
Easley, SC 29640-2142
Phone (864) 859-9855

Hospital & facility affiliations

  • St Francis-Downtown Hospital, Greenville, SC, CCN 420023
  • Prisma Health Greenville Memorial Hospital Hospital, Greenville, SC, CCN 420078

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD51636TNMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St Francis Physician Services Inc CurrentSince Jul 31, 2021 Accepting new patients
St. Francis Hospital, Inc. Current Accepting new patients
Bon Secours Medical Group Greenville Specialty Care LLC CurrentSince May 21, 2022 Accepting new patients
St Francis Hospital Inc CurrentSince Jul 31, 2021 Accepting new patients
St Francis Hospital Inc CurrentSince Jul 31, 2021 Accepting new patients
St Francis Physician Services Inc Cardiovascular Disease CurrentSince Jul 31, 2021 Accepting new patients
Bon Secours Medical Group Greenville Specialty Care LLC Cardiovascular Disease CurrentSince May 21, 2022 Accepting new patients
St Francis Physician Services Inc Past Accepting new patients

Locations

2 Innovation Dr
Ste 330
Greenville, SC 29607
Phone (864) 235-7665

317 Saint Francis Dr
Ste 220
Greenville, SC 29601
Phone (864) 255-1901

2 Innovation Dr
Ste 400
Greenville, SC 29607
Phone (864) 235-7665

1200 Brookfield Blvd
Ste 400B
Greenville, SC 29607
Phone (864) 605-3721

1 Saint Francis Dr
Greenville, SC 29601
Phone (864) 225-1000

125 Commonwealth Dr
Greenville, SC 29615
Phone (864) 225-1800

3970 Grandview Dr
Ste 2300
Simpsonville, SC 29680
Phone (864) 235-7665

Organizations & group practices 8

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 45

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

View all 45

NPI Registry JSON

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

{
    "created_epoch": "1184025600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1861690802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103 W BROADWAY AVE",
            "city": "MARYVILLE",
            "state": "TN",
            "postal_code": "378014703",
            "telephone_number": "865-273-1752",
            "fax_number": "865-273-1755"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "266 JOULE ST",
            "city": "ALCOA",
            "state": "TN",
            "postal_code": "377012422",
            "telephone_number": "865-984-3864",
            "fax_number": "865-380-4095"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DE NAZARETH",
        "first_name": "ANDREW",
        "middle_name": "GREGORY ANTHONY",
        "name_prefix": "Dr.",
        "credential": "M.B.B.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-07-10",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "TN",
            "license": "MD51636",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q006909",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Alcoa, TN

Sources for this page

Verify at the official NPI Registry.