Myrtle Beach Spine Center, Pa is a medicare enrolled "Physical Medicine & Rehabilitation - Neuromuscular Medicine" provider in Myrtle Beach, South Carolina. Their current practice location is
100 Legends Rd Suite A, Myrtle Beach, South Carolina. You can reach out to their office (for appointments etc.) via phone at
(843) 236-9090.
Myrtle Beach Spine Center, Pa is licensed to practice in * (Not Available) (license number ) and it also participates in the medicare program. Myrtle Beach Spine Center, Pa
is enrolled with medicare and should accept medicare assignments and since they are enrolled in medicare, they may order Medicare Part D Prescription drugs, if eligible. The facility's NPI Number is 1962764142.
Healthcare Provider's Profile
| Full Name | Myrtle Beach Spine Center, Pa |
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| Type | Facility |
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| Speciality | Physical Medicine & Rehabilitation - Neuromuscular Medicine |
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| Location | 100 Legends Rd Suite A, Myrtle Beach, South Carolina |
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| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1962764142
- Provider Enumeration Date: 06/13/2012
- Last Update Date: 09/05/2024
Medicare PECOS Information:
- PECOS PAC ID: 0345496717
- Enrollment ID: O20120820000295
Medical Identifiers
Medical identifiers for Myrtle Beach Spine Center, Pa such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1962764142 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 111N00000X | Chiropractor | (* (Not Available)) | Secondary |
| 2081N0008X | Physical Medicine & Rehabilitation - Neuromuscular Medicine | (* (Not Available)) | Primary |
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Secondary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works.
Myrtle Beach Spine Center, Pa acts as a billing entity for following providers:
| Provider Name | Michael P Gambacorta |
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| Provider Type | Practitioner - Chiropractic |
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| Provider Identifiers | NPI Number: 1851393920
PECOS PAC ID: 1153386305
Enrollment ID: I20120824000727 |
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| Provider Name | Michael P Gambacorta |
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| Provider Type | Practitioner - Nurse Practitioner |
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| Provider Identifiers | NPI Number: 1851393920
PECOS PAC ID: 1153386305
Enrollment ID: I20241107002175 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Myrtle Beach Spine Center, Pa is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Myrtle Beach Spine Center, Pa
100 Legends Rd Ste A,
Myrtle Beach, SC 29579-7076
Ph: (919) 394-3225 | Myrtle Beach Spine Center, Pa
100 Legends Rd Suite A,
Myrtle Beach, SC 29579-7076
Ph: (843) 236-9090 |
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