Individual provider Active NPI

Victoria Mae Pregibon, PA-C

  • Surgical Physician Assistant
  • West Columbia, SC
National Provider Identifier
1992302988
Registry record updated Jan 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
4806 Issued in SC
Practice address
2728 Sunset Blvd Ste 400
West Columbia, SC 29169-4872
Phone
(803) 936-7095
Fax
(803) 936-7908
NPI assigned
Oct 3, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 12, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 4806 SC Primary

Addresses

Primary practice location

2728 Sunset Blvd Ste 400
West Columbia, SC 29169-4872

Mailing address

PO Box 6069
West Columbia, SC 29171-6069
Phone (803) 936-7095

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address vpregibon163267@direct.lexmed.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, SC2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20201026002148 GA Practitioner - Physician Assistant 3173943412 Reassigns benefits to 1 organization
I20230330002529 SC Practitioner - Physician Assistant 3173943412 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lexington Health IncGroup PAC ID 2567872070, 905 clinicians

Practice addresses (Care Compare)

2720 Sunset Blvd
West Columbia, SC 29169-4810
Phone (803) 791-2460

2728 Sunset Blvd
Suite 105
West Columbia, SC 29169-4839
Phone (803) 936-7095

811 W Main St
Lexington, SC 29072-2500

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.09 of 100Reported as group
Quality
68.87
Promoting interoperability
100
Improvement activities
40
Cost
78.11

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Lexington County Health Services District Inc Current Accepting new patients
Lexington Health Inc CurrentSince Apr 1, 2023 Accepting new patients
Au Medical Associates Inc CurrentSince Nov 9, 2020 Accepting new patients
Au Medical Associates Inc CurrentSince Nov 9, 2020 Accepting new patients
Lexington Health Inc CurrentSince Apr 1, 2023 Accepting new patients
Lexington County Health Services District, Inc. Past Accepting new patients

Locations

1120 15th St
Augusta, GA 30912
Phone (706) 721-3873

1120 15th St
Ste BI1056
Augusta, GA 30912
Phone (706) 721-2785

811 W Main St
Ste 101
Lexington, SC 29072
Phone (803) 936-7230

146 E Hospital Dr
Ste 400
West Columbia, SC 29169
Phone (803) 936-3300

2728 Sunset Blvd
Ste 105
West Columbia, SC 29169
Phone (803) 936-7045

2728 Sunset Blvd
Ste 400
West Columbia, SC 29169
Phone (803) 936-7095

Organizations & group practices 6

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": "1601683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705017600000",
    "number": "1992302988",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6069",
            "city": "WEST COLUMBIA",
            "state": "SC",
            "postal_code": "291716069",
            "telephone_number": "803-936-7095",
            "fax_number": "803-936-7908"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2728 SUNSET BLVD STE 400",
            "city": "WEST COLUMBIA",
            "state": "SC",
            "postal_code": "291694872",
            "telephone_number": "803-936-7095",
            "fax_number": "803-936-7908"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PREGIBON",
        "first_name": "VICTORIA",
        "middle_name": "MAE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-03",
        "last_updated": "2024-01-12",
        "certification_date": "2024-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "SC",
            "license": "4806",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "vpregibon163267@direct.lexmed.com",
            "affiliation": "N",
            "address_1": "2728 Sunset Blvd Ste 400",
            "city": "West Columbia",
            "state": "SC",
            "country_code": "US",
            "postal_code": "291694872",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in West Columbia, SC

Sources for this page

Verify at the official NPI Registry.