ADVANCED VASCULAR ASSOCIATES A DIVISION OF SELF MEDICAL GROUP
NPI 1124488895
Surgery - Vascular Surgery in Greenwood, SC

Active since February 24, 2016
160 ACADEMY AVE, GREENWOOD, SC 29646(864) 223-8090 Get Directions Write a Review

NPPES record last updated: December 14, 2021. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Dec 14, 2021, Feb 24, 2016 (2 updates tracked since 2016).

About Advanced Vascular Associates A Division Of Self Medical Group NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ADVANCED VASCULAR ASSOCIATES A DIVISION OF SELF MEDICAL GROUP (NPI 1124488895) is a healthcare organization registered as a vascular surgery in Greenwood, South Carolina and active in the NPI registry since February 2016. The organization lists Matthew T Logan, President And Cfo, as its authorized official.

NPPES Registry Identity

NPI1124488895
Entity TypeOrganization
Primary Taxonomy2086S0129X
Legal Business NameSELF MEDICAL GROUP
Location Address160 ACADEMY AVEGreenwood, SC 29646-3808
Mailing Address160 Academy AveGreenwood, SC 29646-3808 · (864) 223-8090
Organization SubpartNo
Authorized OfficialMatthew T LoganPresident And Cfo · (864) 725-4253
Enumeration DateFebruary 24, 2016
Last NPPES UpdateDecember 14, 20212 updates tracked since enumeration
NPPES CertifiedDecember 14, 2021
✔ NPI 1124488895 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtySurgery · Vascular SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code2086S0129X
Definition
A surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart.
Also ListedSurgeryTaxonomy 208600000X
160 ACADEMY AVE, Greenwood, SC 29646

Other Names 1

Other NameAdvanced Vascular Associates A Division Of Self Medical Group

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Advanced Vascular Associates A Division Of Self Medical Group is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

560

Medicare enrollment records show 560 clinicians reassign Medicare billing to Advanced Vascular Associates A Division Of Self Medical Group, which bills Medicare for the services they deliver. Of these, 37 practice at this address and 302 within 10 miles. Listed here are the 20 practicing nearest to this location.

Clinicians by Medicare Specialty 43

Family Practice95
Nurse Practitioner87
Emergency Medicine59
Certified Registered Nurse Anesthetist (CRNA)36
Internal Medicine34
Anesthesiology24
Diagnostic Radiology22
Gastroenterology17
35 other specialties186

Nearest to this location (20)

See all 560
Vascular Surgery
NPI 1104131143
160 ACADEMY AVE
Greenwood, SC 29646
(864) 223-8090
✔ PECOS✔ Accepts MedicareSame address
General Surgery
NPI 1760974661
160 ACADEMY AVE
Greenwood, SC 29646
(864) 223-8090
✔ PECOS✔ Accepts MedicareSame address
Nurse Practitioner
NPI 1730728031
160 ACADEMY AVE
Greenwood, SC 29646
(864) 223-8090
✔ PECOS✔ Accepts MedicareSame address
Gastroenterology
NPI 1811336092
160 ACADEMY AVE
Greenwood, SC 29646
(864) 223-8090
✔ PECOS✔ Accepts MedicareSame address
General Surgery
NPI 1982648549
160 ACADEMY AVE
Greenwood, SC 29646
(864) 223-8090
✔ PECOS✔ Accepts MedicareSame address
Vascular Surgery
NPI 1619083060
160 ACADEMY AVE
Greenwood, SC 29646
(864) 223-8090
✔ PECOSSame address
Nurse Practitioner
NPI 1669048484
160 ACADEMY AVE
Greenwood, SC 29646
(864) 223-8090
✔ PECOS✔ Accepts MedicareSame address
Nurse Practitioner
NPI 1801454046
160 ACADEMY AVE
Greenwood, SC 29646
(864) 223-8090
✔ PECOS✔ Accepts MedicareSame address
General Surgery
NPI 1881072940
160 ACADEMY AVE
Greenwood, SC 29646
(864) 725-4111
✔ PECOS✔ Accepts MedicareSame address
Nurse Practitioner
NPI 1346929742
160 ACADEMY AVE
Greenwood, SC 29646
(864) 223-8090
✔ PECOS✔ Accepts MedicareSame address
General Surgery
NPI 1487174512
160 ACADEMY AVE
Greenwood, SC 29646
(203) 805-2357
✔ PECOS✔ Accepts MedicareSame address
General Surgery
NPI 1780679241
160 ACADEMY AVE
Greenwood, SC 29646
(864) 223-8090
✔ PECOS✔ Accepts MedicareSame address
Gastroenterology
NPI 1932629235
160 ACADEMY AVE
Greenwood, SC 29646
(864) 223-8090
✔ PECOS✔ Accepts MedicareSame address
General Surgery
NPI 1366949703
160 ACADEMY AVE
Greenwood, SC 29646
(864) 223-8090
✔ PECOS✔ Accepts MedicareSame address
Gastroenterology
NPI 1861697740
160 ACADEMY AVE
Greenwood, SC 29646
(864) 223-8090
✔ PECOS✔ Accepts MedicareSame address
Family Practice
NPI 1518540434
155 ACADEMY AVE
Greenwood, SC 29646
(864) 725-4869
✔ PECOSSame address
Family Practice
NPI 1508540097
155 ACADEMY AVE
Greenwood, SC 29646
(864) 725-4865
✔ PECOS✔ Accepts MedicareSame address
Family Practice
NPI 1043698079
155 ACADEMY AVE
Greenwood, SC 29646
(864) 725-4865
✔ PECOSSame address
Family Practice
NPI 1053847889
155 ACADEMY AVE
Greenwood, SC 29646
(864) 725-4865
✔ PECOS✔ Accepts MedicareSame address
Family Practice
NPI 1922665405
155 ACADEMY AVE
Greenwood, SC 29646
(864) 725-4865
✔ PECOS✔ Accepts MedicareSame address
See all 560 clinicians

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Self Medical Group's NPI number?

The NPI number for Self Medical Group is 1124488895. It was assigned to this organization in the NPPES registry on February 24, 2016. The provider is also known as Advanced Vascular Associates A Division Of Self Medical Group.

Where is Self Medical Group located?

Self Medical Group is located at 160 Academy Ave, Greenwood, SC 29646. The listed phone number is (864) 223-8090.

What is Self Medical Group's specialty?

The primary specialty registered for this NPI is Surgery, specializing in Vascular Surgery, with taxonomy code 2086S0129X.

Is Self Medical Group enrolled in Medicare?

Yes. Self Medical Group is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Self Medical Group?

According to the CMS Revalidation Reassignment List (October 2026 release), 560 clinicians in 43 Medicare specialties reassign their Medicare billing to Self Medical Group. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Family Practice (95), Nurse Practitioner (87) and Emergency Medicine (59). Of these, 37 practice at this address and 302 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

What insurance does Self Medical Group accept?

Health plans from Ambetter Health, Ambetter from Absolute Total Care, Ambetter of North Carolina, BlueCross BlueShield of South Carolina and First Choice Next and 1 other insurer list Self Medical Group as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Self Medical Group was last updated on December 14, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.