MS. MARY REGINA DORTENZO RN-ANP NPI 1215105085

NPI Information

  • NPI: 1215105085
  • Provider Name: MS. MARY REGINA DORTENZO, RN-ANP
  • Classification: Nurse Practitioner - 363LA2200X
  • Specialization: Adult Health
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 176 MCSWAIN DR
    WEST COLUMBIA, SC
    ZIP 29169
  • Phone: (803) 767-4465

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NPI Details

MS. Mary Regina Dortenzo, RN-ANP is an adult health nurse practitioner in West Columbia, SC with 29 years of experience. MS. Mary Regina Dortenzo, RN-ANP NPI is 1215105085. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

176 MCSWAIN DR
WEST COLUMBIA, SC
ZIP 29169-825
Phone: (803) 767-4465
Fax: (803) 767-4120

The NPI 1215105085 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Removal of skin and tissue, 20.0 sq cm or less (HCPCS:11042)
  • Established patient office or other outpatient visit, 30-39 minutes (HCPCS:99214)
  • Established patient office or other outpatient visit, 20-29 minutes (HCPCS:99213)
  • Removal of skin and tissue, each additional 20.0 sq cm or less (HCPCS:11045)
  • Removal of tissue from wound, 20.0 sq cm or less (HCPCS:97597)
  • New patient office or other outpatient visit, 45-59 minutes (HCPCS:99204)
  • Application of skin substitute graft to wound of trunk, arms, or legs, 25.0 sq cm or less of wound 100.0 sq cm or less (HCPCS:15271)
  • New patient office or other outpatient visit, 30-44 minutes (HCPCS:99203)

The enumeration date for this NPI number is 2/14/2008 and was last updated on 2/10/2025.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363LA2200XNurse PractitionerAdult Health4097SOUTH CAROLINAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1NP1564MEDICAIDSOUTH CAROLINA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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