ALEXIS NOELLE VETACK MD
NPI 1215861109
Internal Medicine in Charleston, SC

Q: What is Alexis Vetack's NPI number?

The NPI number for Alexis Vetack is 1215861109. It was assigned to this individual provider in the NPPES registry on June 9, 2026.

Q: What is Alexis Vetack's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Q: When was this NPI record last updated?

The NPPES record for Alexis Vetack was last updated on June 9, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 months 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.

Active since June 09, 2026PECOS Enrolled

169 ASHLEY AVE RM 202, CHARLESTON, SC 29425(843) 792-0435 Get Directions Write a Review

NPPES record last updated: June 9, 2026. Verified against the NPPES registry weekly; last sync: November 08, 2026.

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About Alexis Noelle Vetack Md NPPES

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

ALEXIS NOELLE VETACK MD (NPI 1215861109) is an individual internal medicine provider in Charleston, South Carolina, licensed in South Carolina (LL97086) and active in the NPI registry since June 2026. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1215861109

Entity TypeIndividualFemale

Primary Taxonomy207R00000X

Provider Legal NameALEXIS NOELLE VETACKCredential: MD

Location Address169 ASHLEY AVE RM 202Charleston, SC 29425-8905

Mailing Address169 Ashley Ave Rm 202Charleston, SC 29425-8905

Phone(843) 792-0435

Sole ProprietorNo

Enumeration DateJune 9, 2026

NPPES CertifiedJune 9, 2026

✔ NPI 1215861109 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207R00000X

License✔ Licensed in SC · LL97086

Definition

A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

Also ListedPediatricsTaxonomy 208000000X · License LL97086 (SC)

169 ASHLEY AVE RM 202, Charleston, SC 29425

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Alexis Noelle Vetack Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 29425 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$124.04 typical visit price

range $53.57 – $163.84

Typical copayment $31.01 (range $13.39 – $40.96)

Most-billed visit code 99204

Established Patient

$95.12 typical visit price

range $16.96 – $133.52

Typical copayment $23.78 (range $4.24 – $33.38)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

SANAA ABDELMAGEED MD

Surgery