NPIMap

Individual provider Active NPI

Sviatoslav Redko, MD

  • Neurology Physician
  • Conway, SC
National Provider Identifier
1871016022
Registry record updated Jul 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
89337 Issued in SC
Practice address
8024 Myrtle Trace Dr
Conway, SC 29526-8945
Phone
(843) 234-8950
Fax
(843) 234-8951
NPI assigned
Jul 19, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2023

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 89337 SC Primary

Addresses

Primary practice location

8024 Myrtle Trace Dr
Conway, SC 29526-8945

Mailing address

300 Singleton Ridge Rd
Attention PNS Credentialing
Conway, SC 29526-9142
Phone (843) 234-6946

Other identifiers 1

IdentifierTypeStateIssuer
893377MedicaidSC

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
I20230601000944 SC Practitioner - Neurology 7315304631 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Conway Hospital IncGroup PAC ID 7113839606, 127 clinicians

Practice addresses (Care Compare)

8024 Myrtle Trace Dr
Conway, SC 29526-8945
Phone (843) 234-8950

Hospital & facility affiliations

  • Amedisys Home Health of Conway Home health agency, Conway, SC, CCN 427112
  • Well Care Home Health of the Lowcountry Inc Home health agency, Myrtle Beach, SC, CCN 427138
  • Conway Medical Center Hospital, Conway, SC, CCN 420049
  • McLeod Loris Hospital Hospital, Loris, SC, CCN 420105
  • Tidelands Georgetown Memorial Hospital Hospital, Georgetown, SC, CCN 420020
  • Grand Strand Regional Medical Center Hospital, Myrtle Beach, SC, CCN 420085
  • Tidelands Waccamaw Community Hospital Hospital, Murrells Inlet, SC, CCN 420098

Merit-based Incentive Payment System (MIPS)

Final score
52.78 of 100Reported as group
Quality
55.48
Improvement activities
0
Cost
74.21

Procedures performed for Medicare patients

ProcedureNumber of procedures
Skin biopsy12

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
89337SCMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Conway Hospital, Inc. Current Accepting new patients
Conway Hospital, Inc. CurrentSince Jul 1, 2023 Accepting new patients
Conway Hospital, Inc. CurrentSince Jul 1, 2023 Accepting new patients
Conway Hospital, Inc. Past Accepting new patients

Locations

394 Singleton Ridge Rd
Conway, SC 29526
Phone (843) 347-8050

8024 Myrtle Trace Dr
Conway, SC 29526
Phone (843) 234-8950

300 Singleton Ridge Rd
Conway, SC 29526
Phone (843) 234-6946

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": "1500422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689120000000",
    "number": "1871016022",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 SINGLETON RIDGE RD",
            "address_2": "ATTENTION PNS CREDENTIALING",
            "city": "CONWAY",
            "state": "SC",
            "postal_code": "295269142",
            "telephone_number": "843-234-6946"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8024 MYRTLE TRACE DR",
            "city": "CONWAY",
            "state": "SC",
            "postal_code": "295268945",
            "telephone_number": "843-234-8950",
            "fax_number": "843-234-8951"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REDKO",
        "first_name": "SVIATOSLAV",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-07-19",
        "last_updated": "2023-07-12",
        "certification_date": "2023-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "SC",
            "license": "89337",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "893377",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Conway, SC

Sources for this page

Verify at the official NPI Registry.