Individual provider Active NPI

Noemi R Pagan, MD

  • Family Medicine Physician
  • Charleston, SC
National Provider Identifier
1922074475
Registry record updated Jan 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
28816 Issued in SC
Practice address
16 Windermere Blvd
Charleston, SC 29407-7412
Phone
(843) 766-9053
Fax
(843) 766-8853
NPI assigned
Feb 24, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2021

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 0101238238 VA
Family Medicine Physician 207Q00000X 28816 SC Primary

Addresses

Primary practice location

16 Windermere Blvd
Charleston, SC 29407-7412

Mailing address

PO Box 751649
Charlotte, NC 28275-1649
Phone (843) 789-1620

Other identifiers 2

IdentifierTypeStateIssuer
288165MedicaidSC
P00727223OtherSCRAILROAD MEDICARE ID-RSFPN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address Noemi.Pagan@rsfpp.eclinicaldirectplus.com Direct

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
I20070803000316 SC Practitioner - Family Practice 5395836415 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Medical University of South Carolina College of Medicine, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

8536 Palmetto Commerce Pkwy
Suite 401
Ladson, SC 29456-6700

8906 Two Notch Rd
Columbia, SC 29223-6366

Hospital & facility affiliations

  • Colleton Medical Center Hospital, Walterboro, SC, CCN 420030

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0101238238VAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Roper Saint Francis Physicians Network Current Accepting new patients
Roper Saint Francis Physicians Network CurrentSince May 11, 2009 Accepting new patients
Roper Saint Francis Physicians Network Family Medicine CurrentSince May 11, 2009 Accepting new patients
Genesis Healthcare, Inc CurrentSince Oct 14, 2024 Accepting new patients
Genesis Healthcare, Inc. CurrentSince Oct 14, 2024 Accepting new patients
Genesis Healthcare, Inc. Current Accepting new patients
Genesis Healthcare, Inc. Past Accepting new patients

Locations

16 Windermere Blvd
Charleston, SC 29407
Phone (843) 766-9053

201 Cashua St
Darlington, SC 29532
Phone (843) 383-7452

8536 Palmetto Commerce Pkwy
Ste 401
Ladson, SC 29456
Phone (843) 203-2260

2075 Eagle Landing Blvd
North Charleston, SC 29406
Phone (843) 797-5747

457 Spruce St
Walterboro, SC 29488
Phone (843) 584-4353

830 Robertson Blvd
Walterboro, SC 29488
Phone (843) 781-7428

Interoperability endpoints

  • Direct secure messaging: noemi.pagan.1@20108.direct.athenahealth.com
  • Direct secure messaging: noemi.pagan@rsfpp.eclinicaldirectplus.com

Organizations & group practices 7

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": "1140739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611532800000",
    "number": "1922074475",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 751649",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282751649",
            "telephone_number": "843-789-1620",
            "fax_number": "843-724-2440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16 WINDERMERE BLVD",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294077412",
            "telephone_number": "843-766-9053",
            "fax_number": "843-766-8853"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAGAN",
        "first_name": "NOEMI",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-24",
        "last_updated": "2021-01-25",
        "certification_date": "2021-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "0101238238",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SC",
            "license": "28816",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "288165",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE ID-RSFPN",
            "identifier": "P00727223",
            "state": "SC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Noemi.Pagan@rsfpp.eclinicaldirectplus.com",
            "affiliation": "N",
            "endpointDescription": "Document and CCD Exchange",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Patient Care Documents",
            "address_1": "16 Windermere Blvd",
            "city": "Charleston",
            "state": "SC",
            "country_code": "US",
            "postal_code": "294077412",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Charleston, SC

Sources for this page

Verify at the official NPI Registry.