NPIMap

Individual provider Active NPI

Robert Jackson Sherertz, MD

  • Infectious Disease Physician
  • Murrells Inlet, SC
National Provider Identifier
1891770178
Registry record updated Nov 1, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
License
34460 Issued in SC
Practice address
4835 Highway 17
Murrells Inlet, SC 29576-5037
Phone
(843) 449-1640
Fax
(843) 449-1605
NPI assigned
Dec 9, 2005
Last updated
Nov 1, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 1, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Infectious Disease Physician 207RI0200X 34460 SC Primary

Addresses

Primary practice location

4835 Highway 17
Murrells Inlet, SC 29576-5037

Mailing address

1938 Charlie Hall Blvd Unit B
Charleston, SC 29414-6099
Phone (843) 402-0227

Other identifiers 2

IdentifierTypeStateIssuer
440003773OtherRR MEDICARE
Q23772MedicaidSC

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
I20120612000002 SC Practitioner - Internal MedicinePractitioner - Infectious Disease 1254228810 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Infectious Disease
Education
University of Virginia School of Medicine, 1976
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southeastern Hospitalist Services PCGroup PAC ID 3476855420, 301 clinicians

Practice addresses (Care Compare)

809 82ND Pkwy
Myrtle Beach, SC 29572-4607
Phone (843) 692-1000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Southeastern Hospitalist Services PC CurrentSince Jan 1, 2016 Accepting new patients
Wake Forest University Health Sciences Past Accepting new patients
Grand Strand Regional Medical Center LLC Past Accepting new patients

Locations

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

Organizations & group practices 3

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 16

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

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1134086400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1351728000000",
    "number": "1891770178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1938 CHARLIE HALL BLVD UNIT B",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294146099",
            "telephone_number": "843-402-0227",
            "fax_number": "843-402-0232"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4835 HIGHWAY 17",
            "city": "MURRELLS INLET",
            "state": "SC",
            "postal_code": "295765037",
            "telephone_number": "843-449-1640",
            "fax_number": "843-449-1605"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHERERTZ",
        "first_name": "ROBERT",
        "middle_name": "JACKSON",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-09",
        "last_updated": "2012-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "SC",
            "license": "34460",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "440003773",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q23772",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Murrells Inlet, SC

Sources for this page

Verify at the official NPI Registry.