DR. ANDREW R DONATO MD
NPI 1225064140
Emergency Medicine in Columbia, SC

Q: What is Andrew Donato's NPI number?

The NPI number for Andrew Donato is 1225064140. It was assigned to this individual provider in the NPPES registry on June 23, 2006.

Q: What is Andrew Donato's specialty?

The primary specialty registered for this NPI is Emergency Medicine with taxonomy code 207P00000X.

Q: When was this NPI record last updated?

The NPPES record for Andrew Donato was last updated on April 15, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 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 23, 2006PECOS EnrolledAccepts Medicare Assignment

111 DOCTOR CIR, COLUMBIA, SC 29203(800) 491-0909(833) 450-5915 Get Directions Write a Review

NPPES record last updated: April 15, 2025. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Jul 12, 2024, Oct 24, 2023, Oct 27, 2020 and 2 more (5 updates tracked since 2017).

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About Dr. Andrew R Donato Md NPPES

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

DR. ANDREW R DONATO MD (NPI 1225064140) is an individual emergency medicine provider in Columbia, South Carolina, licensed in South Carolina (16890) and active in the NPI registry since June 2006. He is enrolled in Medicare PECOS, is affiliated with Lexington Medical Center, and maintains 2 additional practice locations.

NPPES Registry Identity

NPI1225064140

Entity TypeIndividualMale

Primary Taxonomy207P00000X

Provider Legal NameDR. ANDREW R DONATOCredential: MD

Location Address111 DOCTOR CIRColumbia, SC 29203-6502

Mailing Address111 Doctor CirColumbia, SC 29203-6502 · (800) 491-0909

Phone(800) 491-0909

Fax(833) 450-5915

Sole ProprietorNo

Medical School CMSHahneman Medical College Of The PacificGraduated 1992

Enumeration DateJune 23, 2006

Last NPPES UpdateApril 15, 20255 updates tracked since enumeration

NPPES CertifiedApril 15, 2025

✔ NPI 1225064140 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyEmergency MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207P00000X

License✔ Licensed in SC · 16890

Definition

An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury.

Also ListedGeneral PracticeTaxonomy 208D00000X · License 16890 (SC)

111 DOCTOR CIR, Columbia, SC 29203

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Secondary Practice Locations 2

Location 1811 W Main StLexington, SC 29072-2507 · Phone (803) 358-6100 · Fax (803) 358-6105

Location 2944 Harden StColumbia, SC 29205-1082 · Phone (864) 686-7955 · Fax (864) 686-7986

Other Identifiers 1

Medicaid168909SC

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include BlueCross BlueShield of South Carolina.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Andrew R Donato Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID3870543929

PECOS Enrollment IDI20070212000385

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.

Medicare Billing Reassignments

Medicare enrollment records show Andrew Donato reassigns Medicare billing to 5 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Sc House Calls Inc

Same address

Family Medicine

111 DOCTOR CIR
Columbia, SC 29203

Reassigned Medicare billing, South Carolina enrollment
631 clinicians in this Medicare group

NPI 1518048859 (800) 491-0909

Palmetto Advanced Mobile Wound Care PC

2.0 mi

Family

1122 LADY ST, FL 3
Columbia, SC 29201

Reassigned Medicare billing, South Carolina enrollment
4 clinicians in this Medicare group

NPI 1407709595 (864) 934-8326

Lexington Health Inc

2.2 mi

Obstetrics & Gynecology

700 GERVAIS ST STE 300
Columbia, SC 29201

Reassigned Medicare billing, South Carolina enrollment
1,219 clinicians in this Medicare group

NPI 1750988036 (803) 254-3230

Lexington County Health Services District, Inc.

6.7 mi

Urgent Care

154 SALUDA POINTE CT
Lexington, SC 29072

Reassigned Medicare billing, South Carolina enrollment
61 clinicians in this Medicare group

NPI 1194380600 (803) 785-3590

Carolina Advanced Wound Care LLC

16 mi

Emergency Medicine

116 MATCH POINT DR
Chapin, SC 29036

Reassigned Medicare billing, South Carolina enrollment

NPI 1386441715 (803) 422-6819

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

Areas of Expertise CMS Part B claims 13

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Complex chronic care management services for two or more chronic conditions, each additional 60 minutes of clinical staff time directed by health care professional, per calendar month 99489

Complex chronic care management is a service for patients with multiple chronic conditions. It involves an additional 60 minutes per month of clinical staff time directed by a healthcare professional. This service assists in managing your health conditions effectively.

27,268 services751 patients

Complex chronic care management services for two or more chronic conditions, first 60 minutes of clinical staff time directed by health care professional, per calendar month 99487

Complex chronic care management is a service for patients with two or more long-term health conditions. It involves a healthcare professional directing clinical staff in providing care for the first 60 minutes each month. This helps manage your health conditions effectively.

4,166 services761 patients

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

2,901 services2,007 patients

Chronic care management services for two or more chronic conditions, additional 20 minutes of clinical staff time directed by health care professional, per calendar month 99439

Chronic Care Management services involve regular check-ins with healthcare professionals to manage two or more chronic conditions. It includes an additional 20 minutes of clinical staff time per month, directed by a healthcare professional, to ensure optimal health management.

551 services216 patients

Care management services for behavioral health conditions, 20 minutes or more clinical staff time directed by health care professional 99484

Care management for behavioral health involves a healthcare professional directing clinical staff to provide you with support for 20 minutes or more. This service can include planning your care, coordinating services, and managing your health conditions to improve your overall well-being.

499 services176 patients

Chronic care management services, first 20 minutes of clinical staff time directed by health care professional, per calendar month 99490

Chronic care management services involve a healthcare professional directing clinical staff in managing your chronic conditions. This includes the first 20 minutes per month of services like medication management, care coordination, and health monitoring to help improve your health and quality of life.

426 services275 patients

Advance care planning, first 30 minutes 99497

Advance care planning is a process where you discuss your healthcare preferences with your doctor. This conversation, lasting up to 30 minutes, helps ensure your wishes are respected if you're unable to communicate them in the future. It's about your care, your way.

252 services203 patients

Complex chronic care management services for two or more chronic conditions, each additional 60 minutes of clinical staff time directed by health care professional, per calendar month 99489

147 services12 patients

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

95 services79 patients

Residence visit for established patient with moderate level of medical decision making, per day, if using time, at least 40 minutes 99349

An established patient home visit is a medical appointment conducted at your home, typically lasting around 40 minutes. This service is ideal for patients who may find it difficult to travel to a healthcare facility. During this visit, a healthcare professional will evaluate your health status, manage your care, and answer any health-related questions you may have.

51 services51 patients

Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439

An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.

39 services39 patients

Complex chronic care management services for two or more chronic conditions, first 60 minutes of clinical staff time directed by health care professional, per calendar month 99487

23 services12 patients

New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204

This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.

11 services11 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Lexington Medical Center

Acute Care Hospitals · West Columbia, SC

3/5 CMS rating

OwnershipGovernment - Hospital District or Authority

CMS Certification Number420073

Location2720 Sunset BlvdWest Columbia, SC 29169 · Lexington County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 29203 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

$83.18 typical visit price

range $53.57 – $163.84

Typical copayment $20.79 (range $13.39 – $40.96)

Most-billed visit code 99203

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.

Referred Medical Equipment & Supplies CMS DME claims

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Dynamic adjustable ankle extension/flexion device, includes soft interface material E1815

DME-Orthotic Devices · category DF000N

1 supplier16 claims18 services$90.61 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

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.

LAKETA D RILEY APRN

Nurse Practitioner (Psychiatric/Mental Health)