Individual provider Active NPI

Robert S Leak, MD

  • Orthopaedic Hand Surgery Physician
  • Myrtle Beach, SC
National Provider Identifier
1962468587
Registry record updated Aug 25, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Hand Surgery PhysicianTaxonomy code 207XS0106X
License
23258 Issued in SC
Practice address
210 Village Center Blvd
Suite 200
Myrtle Beach, SC 29579-6683
Phone
(843) 236-3222
Fax
(843) 236-3005
NPI assigned
Apr 22, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Hand Surgery Physician 207XS0106X 23258 SC Primary
Orthopaedic Surgery Physician 207X00000X 23258 SC

Addresses

Primary practice location

210 Village Center Blvd
Suite 200
Myrtle Beach, SC 29579-6683

Mailing address

210 Village Center Blvd
Suite 200
Myrtle Beach, SC 29579-6683
Phone (843) 236-3222

Other identifiers 2

IdentifierTypeStateIssuer
8906243MedicaidNC
T74602MedicaidSC

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
I20100812000709 SC Practitioner - Hand SurgeryPractitioner - Orthopedic Surgery 3274667282 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Hand SurgeryAlso: Orthopedic Surgery
Education
University of Oklahoma College of Medicine, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Orthosc LLCGroup PAC ID 8022370030, 113 clinicians

Practice addresses (Care Compare)

210 Village Ctr Blvd
Suite 200
Myrtle Beach, SC 29579-6706
Phone (843) 353-3460

Hospital & facility affiliations

  • Grand Strand Regional Medical Center Hospital, Myrtle Beach, SC, CCN 420085
  • McLeod Loris Hospital Hospital, Loris, SC, CCN 420105

Merit-based Incentive Payment System (MIPS)

Final score
97.45 of 100Reported as group
Promoting interoperability
97
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Upper limb (arm) arthroscopy (minimally invasive joint repair)1-10
Melanoma (skin cancer) excision1-10
Removal of tissue1-10
Removal of nail tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
23258SCMDOrthopaedic Hand Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Orthosc, LLC Orthopaedic Surgery CurrentSince Apr 1, 2018 Accepting new patients
Orthosc, LLC Orthopaedic Surgery CurrentSince Apr 1, 2018 Accepting new patients
Carolina Bone & Joint Surgery Center Orthopaedic Surgery Current Accepting new patients
Orthosc, LLC Orthopaedic Surgery PastSince May 29, 2022 Accepting new patients

Locations

2376 Cypress Cir
Ste 300
Conway, SC 29526
Phone (843) 347-7222

210 Village Center Blvd
Ste 200
Myrtle Beach, SC 29579
Phone (843) 236-3222

Interoperability endpoints

  • Direct secure messaging: rleak27418@directmcleodehealth.org
  • FHIR API: https://api.platform.athenahealth.com/17161/brand/1/csg/1/fhir/r4
  • Direct secure messaging: robert.leak.1@17161.direct.athenahealth.com

Organizations & group practices 4

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 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": "1145664000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1408924800000",
    "number": "1962468587",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 VILLAGE CENTER BLVD",
            "address_2": "SUITE 200",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295796683",
            "telephone_number": "843-236-3222",
            "fax_number": "843-236-3005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 VILLAGE CENTER BLVD",
            "address_2": "SUITE 200",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295796683",
            "telephone_number": "843-236-3222",
            "fax_number": "843-236-3005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEAK",
        "first_name": "ROBERT",
        "middle_name": "S",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-22",
        "last_updated": "2014-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XS0106X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Hand Surgery",
            "state": "SC",
            "license": "23258",
            "primary": true
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "SC",
            "license": "23258",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8906243",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "T74602",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Myrtle Beach, SC

Sources for this page

Verify at the official NPI Registry.