Individual provider Active NPI

Elizabeth Wagner Bozeman, MD

  • Urology Physician
  • Florence, SC
National Provider Identifier
1891751764
Registry record updated May 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
272604 Issued in NY
Practice address
800 E Cheves St Ste 350
Florence, SC 29506-2649
Phone
(843) 777-7555
Fax
(843) 777-7563
NPI assigned
Apr 21, 2006
Last updated
May 7, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 7, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X 272604 NY Primary

Addresses

Primary practice location

800 E Cheves St Ste 350
Florence, SC 29506-2649

Mailing address

PO Box 601743
Charlotte, NC 28260-1743
Phone (843) 777-7555

Other identifiers 1

IdentifierTypeStateIssuer
TL4813MedicaidSC

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
I20110728000014 SC Practitioner - Urology 3779751235 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
Medical University of South Carolina College of Medicine, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
McLeod Physician Associates IIGroup PAC ID 8224031307, 541 clinicians

Practice addresses (Care Compare)

800 E Cheves St
Suite 350
Florence, SC 29506-2649
Phone (843) 665-2000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
15055SCMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
McLeod Physician Associates II Urology CurrentSince Mar 1, 2024 Accepting new patients
McLeod Physician Associates II CurrentSince Mar 1, 2024 Accepting new patients
McLeod Physician Associates II Past Accepting new patients
Upstate Carolina Radiology PA Past Accepting new patients
The Urology Center of Spartanburg Inc Urology PastSince Sep 1, 1992 Accepting new patients

Locations

506 E Cheves St
#202
Florence, SC 29506

800 E Cheves St
Ste 240
Florence, SC 29506
Phone (843) 777-7950

800 E Cheves St
Ste 350
Florence, SC 29506
Phone (843) 665-2000

800 E Cheves St
Ste 480A
Florence, SC 29506
Phone (843) 777-7337

Interoperability endpoints

  • Direct secure messaging: ebozeman90239@directmcleodehealth.org

Ownership & related parties

All facility ownership & control disclosures 3

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Oswego HospitalOswego, NY, CCN 330218 Hospital Corporate Director Jan 1, 2022
Oswego HospitalOswego, NY, CCN 33S218 Hospital Corporate Director Jan 1, 2022
Seneca Hill Manor IncOswego, NY, CCN 335815 Skilled nursing facility Corporate Director Jan 1, 2022

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 5

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 2

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": "1145577600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746576000000",
    "number": "1891751764",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 601743",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282601743",
            "telephone_number": "843-777-7555",
            "fax_number": "843-777-7102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 E CHEVES ST STE 350",
            "city": "FLORENCE",
            "state": "SC",
            "postal_code": "295062649",
            "telephone_number": "843-777-7555",
            "fax_number": "843-777-7563"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOZEMAN",
        "first_name": "ELIZABETH",
        "middle_name": "WAGNER",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-21",
        "last_updated": "2025-05-07",
        "certification_date": "2025-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "NY",
            "license": "272604",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "TL4813",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Florence, SC

Sources for this page

Verify at the official NPI Registry.