Individual provider Active NPI

Kenneth Hugh Tomczyk, D.O.

  • Family Medicine Physician
  • Ridgeland, SC
National Provider Identifier
1902097512
Registry record updated Jun 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
93632 Issued in SC
Practice address
50 Terrace Dr
Ridgeland, SC 29936-5097
Phone
(843) 547-4765
Fax
(843) 547-4766
NPI assigned
Aug 8, 2007
Last updated
Jun 17, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X OS013802 PA
Family Medicine Physician 207Q00000X 93632 SC Primary

Addresses

Primary practice location

50 Terrace Dr
Ridgeland, SC 29936-5097

Mailing address

50 Terrace Dr
Ridgeland, SC 29936-5097
Phone (843) 547-4765

Other identifiers 1

IdentifierTypeStateIssuer
102173336MedicaidPA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ktomczyk84899@direct.geisinger.edu Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, SC2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20080724000354 PA Practitioner - Family Practice 8224101225 Reassigns benefits to 1 organization
I20250616001398 SC Practitioner - Family Practice 8224101225 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Lake Erie College of Osteopathic Medicine, Erie, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Ochsner 65 Plus HH Okatie CrossingGroup PAC ID 5294181939, 6 clinicians
Cora South Carolina LLCGroup PAC ID 3173766334, shared by 6 NPIs, 220 clinicians

Practice addresses (Care Compare)

50 Terrace Dr
Ridgeland, SC 29936-5097
Phone (843) 547-4765

876 Fording Island Rd
Bluffton, SC 29910-8677
Phone (843) 507-8473

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of nail tissue1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Geisinger Clinic Family Medicine CurrentSince Jan 1, 1990 Accepting new patients
Ochsner 65 Plus HH Okatie Crossing CurrentSince Jun 30, 2025 Accepting new patients
Geisinger Clinic CurrentSince Aug 1, 2008 Accepting new patients
Geisinger Clinic Family Medicine CurrentSince Aug 1, 2008 Accepting new patients
Geisinger Clinic PastSince Jan 1, 1990 Accepting new patients
Geisinger Clinic Family Medicine PastSince Jan 1, 1990 Accepting new patients
Geisinger Clinic PastSince Jan 1, 1990 Accepting new patients
Geisinger Clinc PastSince Jan 1, 1990 Accepting new patients
Geisinger Clinic Family Medicine PastSince Jan 1, 1990 Accepting new patients
Geisinger Clinic Family Medicine PastSince Jan 1, 1990 Accepting new patients
Geisinger Clinic Family Medicine PastSince Jan 1, 1990 Accepting new patients
Geisinger Clinic PastSince Jan 1, 1990 Accepting new patients
Geisinger Clinic PastSince Jan 1, 1990 Accepting new patients
Geisinger Clinic Family Medicine PastSince Jan 1, 1990 Accepting new patients
Geisinger Clinic PastSince Jan 1, 1990 Accepting new patients
Geisinger Clinic Family Medicine PastSince Jan 1, 1990 Accepting new patients
Geisinger Clinic PastSince Jan 1, 1990 Accepting new patients
Geisinger Clinic PastSince Jan 1, 1990 Accepting new patients
Geisinger Lewistown Hospital PastSince Jan 1, 1990 Accepting new patients
Geisinger Clinic Family Medicine PastSince Jan 1, 1990 Accepting new patients
Geisinger Clinic PastSince Jan 1, 1990 Accepting new patients
Geisinger Clinic Family Medicine PastSince Jan 1, 1990 Accepting new patients
Geisinger Clinic Family Medicine PastSince Jan 1, 1990 Accepting new patients
Geisinger Clinic PastSince Jan 1, 1990 Accepting new patients
Geisinger Clinic PastSince Jan 1, 1990 Accepting new patients
Geisinger Clinic Family Medicine PastSince Jan 1, 1990 Accepting new patients
Geisinger Clinic PastSince Jan 1, 1990 Accepting new patients
Geisinger Clinic PastSince Jan 1, 1990 Accepting new patients
Geisinger Clinic PastSince Jan 1, 1990 Accepting new patients
Geisinger Clinic PastSince Jan 1, 1990 Accepting new patients
Geisinger Clinic PastSince Jan 1, 1990 Accepting new patients

Locations

114 Lt Michael Cleary Dr
Dallas, PA 18612
Phone (570) 255-1178

100 N Academy Ave
Danville, PA 17822

499 Wyoming Ave
Kingston, PA 18704
Phone (570) 283-2161

56 Jam House Rd
Mifflin, PA 17058
Phone (717) 436-8986

12 Kirby Ave
Mountain Top, PA 18707
Phone (570) 474-5978

125 Scranton Pocono Hwy
Scranton, PA 18505
Phone (570) 342-8500

3 W Olive St
Scranton, PA 18508
Phone (570) 207-4054

531 Mt Pleasant Dr
Scranton, PA 18503
Phone (570) 342-8500

35 S Mountain Blvd
Wilkes Barre, PA 18707
Phone (570) 474-5072

50 Terrace Dr
Ridgeland, SC 29936
Phone (843) 547-4765

Interoperability endpoints

  • Direct secure messaging: ktomczyk2433758@direct.ochsner.org
  • Direct secure messaging: ktomczyk84899@direct.geisinger.edu

Organizations & group practices 31

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.

View all 31

Hospital & facility affiliations 7

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": "1186531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750118400000",
    "number": "1902097512",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 TERRACE DR",
            "city": "RIDGELAND",
            "state": "SC",
            "postal_code": "299365097",
            "telephone_number": "843-547-4765",
            "fax_number": "843-547-4766"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 TERRACE DR",
            "city": "RIDGELAND",
            "state": "SC",
            "postal_code": "299365097",
            "telephone_number": "843-547-4765",
            "fax_number": "843-547-4766"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TOMCZYK",
        "first_name": "KENNETH",
        "middle_name": "HUGH",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-08-08",
        "last_updated": "2025-06-17",
        "certification_date": "2025-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "OS013802",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SC",
            "license": "93632",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "102173336",
            "state": "PA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ktomczyk84899@direct.geisinger.edu",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "3 W Olive St",
            "city": "Scranton",
            "state": "PA",
            "country_code": "US",
            "postal_code": "185082572",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Ridgeland, SC

Sources for this page

Verify at the official NPI Registry.