| Compass Carolina Health Systems Pa | |
|
1483 Tobias Gadson Blvd Ste 201 Charleston SC 29407-4796 | |
| (843) 745-5153 | |
| (843) 766-8606 |
| Full Name | Compass Carolina Health Systems Pa |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 1483 Tobias Gadson Blvd Ste 201, Charleston, South Carolina |
| Authorized Official Name and Position | Scott Segal (CEO/PRESIDENT) |
| Authorized Official Contact | 8888526672 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Compass Carolina Health Systems Pa 1065 Ne 125th St Ste 300 North Miami FL 33161-5833 Ph: (888) 852-6672 | Compass Carolina Health Systems Pa 1483 Tobias Gadson Blvd Ste 201 Charleston SC 29407-4796 Ph: (843) 745-5153 |
| NPI Number | 1346488251 |
|---|---|
| Provider Enumeration Date | 01/30/2009 |
| Last Update Date | 07/28/2021 |
| Certification Date | 07/28/2021 |
| Medicare PECOS PAC ID | 7214084870 |
|---|---|
| Medicare Enrollment ID | O20090416000627 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346488251 | NPI | - | NPPES |
| Provider Name | Eduardo Cifuentes |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1235161274 PECOS PAC ID: 6901876457 Enrollment ID: I20040730000506 |
| Provider Name | Steven Gerald Lopez |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1356459218 PECOS PAC ID: 8820099658 Enrollment ID: I20070123000070 |
| Provider Name | Rukhsana Wajahat Mirza |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1649301482 PECOS PAC ID: 3375636491 Enrollment ID: I20070906000249 |
| Provider Name | Kim Cronenwett |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1275851594 PECOS PAC ID: 3971636325 Enrollment ID: I20100805000259 |
| Provider Name | Manish Sunder Karamchandani |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1770078933 PECOS PAC ID: 5890030845 Enrollment ID: I20210611000665 |
| Provider Name | Luke Christian Zona |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1568037000 PECOS PAC ID: 9638575327 Enrollment ID: I20240221000081 |
| Provider Name | Lucas Traub Ribbens |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1992437347 PECOS PAC ID: 7810365236 Enrollment ID: I20240919000551 |
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