Dr Charles M Nieto, MD is a medicare enrolled "Internal Medicine" physician in Ridgeville, South Carolina. His current practice location is
4789 State Rd, Ridgeville, South Carolina. You can reach out to his office (for appointments etc.) via phone at
(843) 688-5311.
Dr Charles M Nieto is licensed to practice in New York (license number 218850) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1992785653.
Physician's Profile
| Full Name | Dr Charles M Nieto |
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| Gender | Male |
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| Speciality | Internal Medicine |
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| Location | 4789 State Rd, Ridgeville, South Carolina |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1992785653
- Provider Enumeration Date: 01/19/2006
- Last Update Date: 07/21/2022
Medicare PECOS Information:
- PECOS PAC ID: 3678530045
- Enrollment ID: I20050718000512
Medical Identifiers
Medical identifiers for Dr Charles M Nieto such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1992785653 | NPI | - | NPPES |
| 44929064 | Medicaid | CO | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 207R00000X | Internal Medicine | DR44149 (Colorado) | Secondary |
| 207R00000X | Internal Medicine | 218850 (New York) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Dr Charles M Nieto allows following entities to bill medicare on his behalf.
| Entity Name | Ketchikan Indian Corporation |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1821120486
PECOS PAC ID: 8426043761
Enrollment ID: O20050623000335 |
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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. Dr Charles M Nieto 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 |
|---|
Dr Charles M Nieto, MD
2960 Tongass Ave,
Ketchikan, AK 99901-5742
Ph: (907) 228-4900 | Dr Charles M Nieto, MD
4789 State Rd,
Ridgeville, SC 29472-6921
Ph: (843) 688-5311 |
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