Individual provider Active NPI

Mary S. Macdonald, PA-C

  • Medical Physician Assistant
  • Charleston, SC
National Provider Identifier
1902990971
Registry record updated Sep 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
740 Issued in SC
Practice address
2085 Henry Tecklenburg Dr
Charleston, SC 29414-7710
Phone
(843) 577-6957
Fax
(843) 577-6523
NPI assigned
Oct 3, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 740 SC Primary

Addresses

Primary practice location

2085 Henry Tecklenburg Dr
Charleston, SC 29414-7710

Mailing address

PO Box 751874
Charlotte, NC 28275-1874
Phone (843) 402-5200

Other identifiers 1

IdentifierTypeStateIssuer
5276PAMedicaidSC

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221102001687 SC Practitioner - Physician Assistant 7113226317 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Medical University of South Carolina College of Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bon Secours St Francis Xavier Hospital IncGroup PAC ID 8325008717, 202 clinicians

Practice addresses (Care Compare)

125 Doughty St
Suite 500
Charleston, SC 29403-5744
Phone (843) 577-6957

2085 Henry Tecklenburg Dr
Charleston, SC 29414-7710
Phone (843) 577-6957

3510 N Hwy 17
Suite 300
Mt Pleasant, SC 29466-8230
Phone (843) 577-6957

Hospital & facility affiliations

  • Bon Secours-St Francis Xavier Hospital Hospital, Charleston, SC, CCN 420065
  • Mount Pleasant Hospital Hospital, Mount Pleasant, SC, CCN 420104
  • Roper Hospital Hospital, Charleston, SC, CCN 420087
  • Roper St Francis Hospital-Berkeley Inc Hospital, Summerville, SC, CCN 420110

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Bon Secours St. Francis Xavier Hospital, Inc. CurrentSince Nov 6, 2022 Accepting new patients
Bon Secours St Francis Xavier Hospital, Inc. CurrentSince Nov 6, 2022 Accepting new patients

Locations

2085 Henry Tecklenburg Dr
Charleston, SC 29414
Phone (843) 577-6957

2085 Henry Tecklenburg Dr
Fl 2
Charleston, SC 29414
Phone (843) 577-6957

Interoperability endpoints

  • Direct secure messaging: mmacdonald95061@direct.bsmhealth.org

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 and National Provider Directory roles.

Hospital & facility affiliations 4

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": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758153600000",
    "number": "1902990971",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 751874",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282751874",
            "telephone_number": "843-402-5200",
            "fax_number": "843-402-5296"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2085 HENRY TECKLENBURG DR",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294147710",
            "telephone_number": "843-577-6957",
            "fax_number": "843-577-6523"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACDONALD",
        "first_name": "MARY",
        "middle_name": "S.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-03",
        "last_updated": "2025-09-18",
        "certification_date": "2025-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "SC",
            "license": "740",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5276PA",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, SC

Sources for this page

Verify at the official NPI Registry.