NPIMap

Individual provider Active NPI

Ishan Bhansaly, M.D.

  • Family Medicine Physician
  • Greenville, SC
National Provider Identifier
1972824357
Registry record updated Oct 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
32920 Issued in SC
Practice address
701 Grove Rd FL 5
Greenville, SC 29605
Phone
(864) 455-4411
NPI assigned
Jun 19, 2010
Last updated
Oct 31, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 2021-02145 NC
Family Medicine Physician 207Q00000X 32920 SC Primary
Hospitalist Physician 208M00000X 2021-02145 NC
Hospitalist Physician 208M00000X 32920 SC

Addresses

Primary practice location

701 Grove Rd FL 5
Greenville, SC 29605

Mailing address

1 Independence PT Ste 212
Greenville, SC 29615-4536
Phone (864) 797-6174

Other practice location 1

200 Fleetwood Dr
Easley, SC 29640
Phone (864) 442-7200

Other practice location 2

3205 Randall Pkwy Ste 105
Wilmington, NC 28403-2565
Phone (910) 742-9243

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC, NC2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20131003000071 SC Practitioner - Family PracticePractitioner - Emergency MedicinePractitioner - Hospitalist 6507004157 Reassigns benefits to 7 organizations
I20220203001128 NC Practitioner - Family PracticePractitioner - Hospitalist 6507004157 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Emergency Medicine, Hospitalist
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Self Medical GroupGroup PAC ID 6002953916, 393 clinicians
Lifesource of North CarolinaGroup PAC ID 7416132428, 172 clinicians
Lifesource Prime IncGroup PAC ID 7810336385, shared by 3 NPIs, 52 clinicians
24 On Physicians PCGroup PAC ID 5698688141, 274 clinicians

Practice addresses (Care Compare)

1325 Spring St
Greenwood, SC 29646-3860
Phone (864) 725-4111

210 Freeman Farm Rd
Duncan, SC 29334-9398
Phone (864) 968-5123

3205 Randall Pkwy
Suite 105
Wilmington, NC 28403-2565
Phone (910) 742-9243

701 Grove Rd
Greenville, SC 29605-4210

800 N Fant St
Anderson, SC 29621-5708
Phone (770) 740-0895

939 Springdale Dr
Clinton, SC 29325-7266
Phone (910) 742-9243

955 Ribaut Rd
Beaufort, SC 29902-5441
Phone (843) 522-5005

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Prisma Health University Medical Group CurrentSince Apr 23, 2018 Accepting new patients
Self Medical Group Hospitalist CurrentSince Oct 1, 2023 Accepting new patients
Vitalen Inpatient Care PC Hospitalist CurrentSince Jan 12, 2021 Accepting new patients
Prisma Health University Medical Group Family Medicine CurrentSince Apr 23, 2018 Accepting new patients
Prisma Health University Medical Group Family Medicine Current Accepting new patients
Usacs Integrated Acute Care Services of North Carolina, PLLC CurrentSince Aug 22, 2023 Accepting new patients
Lifesource Prime Inc Family Medicine CurrentSince Jun 1, 2024 Accepting new patients
24 On Physicians, PC Hospitalist CurrentSince Sep 1, 2019 Accepting new patients
Lifesource Prime Inc Family Medicine CurrentSince Aug 29, 2024 Accepting new patients
Cogent Healthcare of Georgia PC Family Medicine CurrentSince Nov 18, 2017 Accepting new patients
Vitalen Inpatient Care, PC Hospitalist CurrentSince Jan 12, 2021 Accepting new patients
Self Medical Group CurrentSince Oct 1, 2023 Accepting new patients
Lifesource of North Carolina CurrentSince Dec 1, 2020 Accepting new patients
24 On Physicians, P.C. Hospitalist CurrentSince Sep 1, 2019 Accepting new patients
Lifesource of North Carolina Family Medicine CurrentSince Oct 30, 2021 Accepting new patients
Lifesource Prime Inc Family Medicine CurrentSince Jun 1, 2024 Accepting new patients
Lifesource of North Carolina Family Medicine CurrentSince Dec 1, 2020 Accepting new patients
Self Medical Group Current Accepting new patients
Anmed Health Past Accepting new patients
Greenville Health System Past Accepting new patients

Locations

75 Remittance Dr
Dept 6764
Chicago, IL 60675

1144 N Road St
Elizabeth Cty, NC 27909
Phone (252) 384-4610

3205 Randall Pkwy
Ste 105
Wilmington, NC 28403
Phone (910) 338-2880

302 University Pkwy
Aiken, SC 29801
Phone (803) 279-3940

955 Ribaut Rd
Beaufort, SC 29902
Phone (803) 522-5200

210 Freeman Farm Rd
Duncan, SC 29334
Phone (864) 968-5123

200 Fleetwood Dr
Easley, SC 29640
Phone (864) 442-7200

200 Fleetwood Dr
#4
Easley, SC 29640

1 Independence Pt
Ste 212
Greenville, SC 29615
Phone (864) 797-6306

1 Saint Francis Dr
Greenville, SC 29601
Phone (864) 225-1000

125 Commonwealth Dr
Greenville, SC 29615
Phone (864) 225-1800

2A Cleveland Ct
Greenville, SC 29607
Phone (864) 271-7761

701 Grove Rd
Fl 5
Greenville, SC 29605
Phone (864) 455-4411

1325 Spring St
Greenwood, SC 29646
Phone (864) 227-4111

2605 Kinard St
Ste 200
Newberry, SC 29108
Phone (803) 276-1866

1115 Wren School Rd
Piedmont, SC 29673
Phone (864) 859-0740

1915 Ebenezer Rd
Rock Hill, SC 29732
Phone (305) 866-9951

Interoperability endpoints

  • Direct secure messaging: ibhansaly212204@direct.ghs.myhfn.org
  • Direct secure messaging: ibhansaly32165@direct.anmedhealth.net
  • Direct secure messaging: ibhansaly541008@selfregional.direct-ci.net

Organizations & group practices 20

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 20

Hospital & facility affiliations 51

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 51

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1276905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730332800000",
    "number": "1972824357",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 INDEPENDENCE PT STE 212",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296154536",
            "telephone_number": "864-797-6174"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 GROVE RD FL 5",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "29605",
            "telephone_number": "864-455-4411"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "200 Fleetwood Dr",
            "address_purpose": "LOCATION",
            "city": "Easley",
            "state": "SC",
            "postal_code": "29640",
            "country_code": "US",
            "telephone_number": "864-442-7200",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3205 Randall Pkwy Ste 105",
            "address_purpose": "LOCATION",
            "city": "Wilmington",
            "state": "NC",
            "postal_code": "284032565",
            "country_code": "US",
            "telephone_number": "910-742-9243",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BHANSALY",
        "first_name": "ISHAN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-06-19",
        "last_updated": "2024-10-31",
        "certification_date": "2024-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "2021-02145",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SC",
            "license": "32920",
            "primary": true
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "NC",
            "license": "2021-02145",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "SC",
            "license": "32920",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, SC

Sources for this page

Verify at the official NPI Registry.