Individual provider Active NPI

Eric Robert Friedman, M.D.

  • Sports Medicine (Emergency Medicine) Physician
  • Baltimore, MD
National Provider Identifier
1891236162
Registry record updated Jul 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Emergency Medicine) PhysicianTaxonomy code 207PS0010X
License
85453 Issued in SC
Practice address
110 S Paca St
6TH Floor, Suite 200,
Baltimore, MD 21201-1642
Phone
(410) 328-8667
NPI assigned
Mar 20, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 3, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Emergency Medicine) Physician 207PS0010X 85453 SC Primary
Student in an Organized Health Care Education/Training Program 390200000X 566314061 NY

Addresses

Primary practice location

110 S Paca St
6TH Floor, Suite 200,
Baltimore, MD 21201-1642

Mailing address

9330 Medical Plaza Dr
North Charleston, SC 29406-9104
Phone (845) 249-0938

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
I20210816000138 SC Practitioner - Emergency Medicine 3476828351 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Wake Forest University School of Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bright McConnell III MD LLCGroup PAC ID 2567479595, 4 clinicians
Acs Primary Care Physicians - Southeast PCGroup PAC ID 5193620714, 409 clinicians

Practice addresses (Care Compare)

900 Island Park Dr
Suite 105
Daniel Island, SC 29492-7560
Phone (843) 284-5200

9330 Medical Plaza Dr
Charleston, SC 29406-9104
Phone (843) 797-7000

Hospital & facility affiliations

  • Trident Medical Center Hospital, Charleston, SC, CCN 420079

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
85453SCMDSports Medicine (Emergency Medicine) Physician
566314061NYMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Acs Primary Care Physicians - Southeast PC CurrentSince Aug 1, 2021 Accepting new patients
Bright McConnell III MD LLC CurrentSince Jan 7, 2022 Accepting new patients

Locations

900 Island Park Dr
Ste 105
Daniel Island, SC 29492
Phone (843) 284-5200

809 82nd Pkwy
Myrtle Beach, SC 29572
Phone (843) 291-7182

9330 Medical Plaza Dr
North Charleston, SC 29406
Phone (843) 554-6366

Organizations & group practices 2

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 1

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": "1489968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688342400000",
    "number": "1891236162",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9330 MEDICAL PLAZA DR",
            "city": "NORTH CHARLESTON",
            "state": "SC",
            "postal_code": "294069104",
            "telephone_number": "845-249-0938"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 S PACA ST",
            "address_2": "6TH FLOOR, SUITE 200,",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212011642",
            "telephone_number": "410-328-8667"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRIEDMAN",
        "first_name": "ERIC",
        "middle_name": "ROBERT",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-03-20",
        "last_updated": "2023-07-03",
        "certification_date": "2023-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207PS0010X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Sports Medicine",
            "state": "SC",
            "license": "85453",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NY",
            "license": "566314061",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.