Individual provider Active NPI

Samuel Nels Andersen, MD

  • Radiation Oncology Physician
  • Myrtle Beach, SC
National Provider Identifier
1942769997
Registry record updated Sep 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiation Oncology PhysicianTaxonomy code 2085R0001X
License
MMD.91586 Issued in SC
Practice address
4708 Oleander Dr
Myrtle Beach, SC 29577-5742
Phone
(843) 449-9415
NPI assigned
Mar 19, 2019
Last updated
Sep 19, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Radiation Oncology Physician 2085R0001X MMD.91586 SC Primary

Addresses

Primary practice location

4708 Oleander Dr
Myrtle Beach, SC 29577-5742

Mailing address

8121 Rourk St
Myrtle Beach, SC 29572-4128

Other practice location 1

8059 Myrtle Trace Dr
Conway, SC 29526-8946
Phone (843) 234-5505

Other practice location 2

4600 Wild Iris Dr
Myrtle Beach, SC 29577
Phone (843) 449-9415

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
I20240709001280 SC Practitioner - Radiation Oncology 7810227485 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Radiation Oncology
Education
Medical University of South Carolina College of Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Coastal Cancer Center LLCGroup PAC ID 1456265503, 22 clinicians

Practice addresses (Care Compare)

4708 Oleander Dr
Myrtle Beach, SC 29577-5742
Phone (843) 449-9415

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94.12 of 100Reported as group
Promoting interoperability
91
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MMD.91586SCMDRadiation Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Coastal Cancer Center LLC CurrentSince Aug 5, 2024 Accepting new patients
Coastal Cancer Center LLC Radiation Oncology CurrentSince Aug 5, 2024 Accepting new patients
Coastal Cancer Center LLC Past Accepting new patients

Locations

8059 Myrtle Trace Dr
Conway, SC 29526
Phone (843) 234-5504

4600 Wild Iris Dr
Myrtle Beach, SC 29577
Phone (843) 449-9415

4708 Oleander Dr
Myrtle Beach, SC 29577
Phone (843) 449-9415

8121 Rourk St
Myrtle Beach, SC 29572
Phone (843) 692-5000

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 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": "1552953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758240000000",
    "number": "1942769997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8121 ROURK ST",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295724128"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4708 OLEANDER DR",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295775742",
            "telephone_number": "843-449-9415"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8059 Myrtle Trace Dr",
            "address_purpose": "LOCATION",
            "city": "Conway",
            "state": "SC",
            "postal_code": "295268946",
            "country_code": "US",
            "telephone_number": "843-234-5505",
            "fax_number": "843-234-5507",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4600 Wild Iris Dr",
            "address_purpose": "LOCATION",
            "city": "Myrtle Beach",
            "state": "SC",
            "postal_code": "29577",
            "country_code": "US",
            "telephone_number": "843-449-9415",
            "fax_number": "843-449-2160",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ANDERSEN",
        "first_name": "SAMUEL",
        "middle_name": "NELS",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-03-19",
        "last_updated": "2025-09-19",
        "certification_date": "2025-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "SC",
            "license": "MMD.91586",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Myrtle Beach, SC

Sources for this page

Verify at the official NPI Registry.