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RYA KAPLAN MD
NPI 1225070436
Internal Medicine - Gastroenterology in Mount Pleasant, SC

Active since June 12, 2006PECOS EnrolledAccepts Medicare Assignment
874 WHIPPLE RD STE 100, MOUNT PLEASANT, SC 29464(843) 606-4025(803) 325-2484 Get Directions Write a Review

NPPES record last updated: January 6, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jan 6, 2022, Feb 8, 2019, Oct 30, 2018 and 1 more (4 updates tracked since 2018).

About Rya Kaplan Md NPPES

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

RYA KAPLAN MD (NPI 1225070436) is an individual gastroenterology provider in Mount Pleasant, South Carolina, licensed in South Carolina (23097) and active in the NPI registry since June 2006. She is enrolled in Medicare PECOS, is affiliated with Musc Medical Center, and maintains 2 additional practice locations.

NPPES Registry Identity

NPI1225070436
Entity TypeIndividualFemale
Primary Taxonomy207RG0100X
Provider Legal NameRYA KAPLANCredential: MD
Location Address874 WHIPPLE RD STE 100Mount Pleasant, SC 29464-8900
Mailing Address9221 University Blvd, Suite 102North Charleston, SC 29406-9148 · (843) 576-0700 · Fax (843) 576-0701
Phone(843) 606-4025
Fax(803) 325-2484
Sole ProprietorYes
Medical School CMSUniversity Of South Carolina School Of MedicineGraduated 2000
Enumeration DateJune 12, 2006
Last NPPES UpdateJanuary 6, 20224 updates tracked since enumeration
NPPES CertifiedJanuary 6, 2022
✔ NPI 1225070436 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · GastroenterologyAllopathic & Osteopathic Physicians
Taxonomy Code207RG0100X
Licenses✔ Licensed in SC · 23097✔ Licensed in FL · ME95400
Definition
An internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal organs.
874 WHIPPLE RD STE 100, Mount Pleasant, SC 29464
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Secondary Practice Locations 2

Location 1880 Island Park Dr Unit 210Daniel Island, SC 29492-2902 · Phone (843) 606-4025 · Fax (803) 325-2484
Location 2202 Nexton Square DrSummerville, SC 29486-7911 · Phone (843) 936-5970 · Fax (843) 936-5971

Other Identifiers 1

Medicaid230976SC

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Absolute Total Care, Ambetter of North Carolina, BlueCross BlueShield of South Carolina and more.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Rya Kaplan 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 ID2860495827
PECOS Enrollment IDI20101015000801
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.

Areas of Expertise CMS Part B claims 10

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.

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.
184 services119 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.
157 services157 patients
Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope 43239
This procedure involves using a thin, flexible tube with a light and camera, known as an endoscope, to examine the esophagus, stomach, and upper part of the small intestine. Small tissue samples are taken for further examination to help diagnose various conditions.
57 services54 patients
New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203
This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.
39 services39 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.
34 services33 patients
Biopsy of large bowel using a flexible endoscope 45380
A biopsy of the large bowel using a flexible endoscope is a procedure where a thin, flexible tube with a camera is inserted through the rectum to examine the bowel. If abnormal tissue is found, a small sample is taken for further examination. This helps in diagnosing conditions like inflammation, polyps, or cancer.
31 services31 patients

Hospital Affiliations CMS Care Compare

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

Musc Medical Center

Acute Care Hospitals · Charleston, SC
2/5 CMS rating
OwnershipGovernment - Hospital District or Authority
CMS Certification Number420004
Location169 Ashley AveCharleston, SC 29425 · Charleston County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 29464 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.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

Reported Quality Measures

Colorectal Cancer Screening
Percentage of adults 50-75 years of age who had appropriate screening for colorectal cancer
93%420 patients5/55-star benchmark: 85%
Diabetes: Foot Exam
The percentage of patients 18-75 years of age with diabetes (type 1 and type 2) who received a foot exam (visual inspection and sensory exam with mono filament and a pulse exam) during the measurement year
21%52 patients1/55-star benchmark: 98%
Diabetes: Medical Attention for Nephropathy
The percentage of patients 18-75 years of age with diabetes who had a nephropathy screening test or evidence of nephropathy during the measurement period
81%52 patients4/55-star benchmark: 99%
e-Prescribing
At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.
89%1,195 patients3/55-star benchmark: 99%
Falls: Screening for Future Fall Risk
Percentage of patients 65 years of age and older who were screened for future fall risk during the measurement period
93%257 patients4/55-star benchmark: 99%
Health Information Exchange
The MIPS eligible clinician that transitions or refers their patient to another setting of care or health care clinician (1) uses CEHRT to create a summary of care record; and (2) electronically transmits such summary to a receiving health care clinician for…
42%144 patients2/55-star benchmark: 88%
Medication Reconciliation
The MIPS eligible clinician performs medication reconciliation for at least one transition of care in which the patient is transitioned into the care of the MIPS eligible clinician.
98%1,555 patients4/55-star benchmark: 100%
Patient-Specific Education
The MIPS eligible clinician must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide access to those materials to at least one unique patient seen by the MIPS eligible clinician.
91%898 patients4/55-star benchmark: 97%
Pneumococcal Vaccination Status for Older Adults
Percentage of patients 65 years of age and older who have ever received a pneumococcal vaccine
37%257 patients2/55-star benchmark: 90%
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan
Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the previous twelve months AND with a BMI outside of normal parameters, a follow-up plan is documented during the encounter or during the previous…
35%809 patients2/55-star benchmark: 97%
Preventive Care and Screening: Influenza Immunization
Percentage of patients aged 6 months and older seen for a visit between October 1 and March 31 who received an influenza immunization OR who reported previous receipt of an influenza immunization
77%252 patients4/55-star benchmark: 88%
Provide Patient Access
At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician's discretion to withhold…
100%898 patients5/55-star benchmark: 100%
Secure Messaging
For at least one unique patient seen by the MIPS eligible clinician during the performance period, a secure message was sent using the electronic messaging function of CEHRT to the patient (or the patient-authorized representative), or in response to a secure…
33%898 patients2/55-star benchmark: 89%
Use of High-Risk Medications in the Elderly
Percentage of patients 65 years of age and older who were ordered high-risk medications. Two rates are submitted. 1) Percentage of patients who were ordered at least one high-risk medication.
Lower rates are better for this measure.
Patients 2+: 0% · 242 patients
0%242 patients5/55-star benchmark: 100%
View, Download, or Transmit (VDT)
At least one patient seen by the MIPS eligible clinician during the performance period (or patient-authorized representative) views, downloads or transmits their health information to a third party during the performance period.
12%898 patients
Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Referred Medical Equipment & Supplies CMS DME claims 2

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

Enteral feeding supply kit; syringe fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape B4034
Other-Enteral and Parenteral · category OB006N
1 supplier11 claims334 services$4.16 avg. paid by Medicare
Enteral formula, nutritionally complete, calorically dense (equal to or greater than 1.5 kcal/ml) with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit B4152
Other-Enteral and Parenteral · category OB006N
1 supplier14 claims7,051 services$0.39 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

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

EAST COOPER PHYSICIAN NETWORK, LLC
Family Medicine
874 WHIPPLE RD STE 100
MOUNT PLEASANT, SC 29464
Charleston County (843) 606-4025

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 Rya Kaplan's NPI number?

The NPI number for Rya Kaplan is 1225070436. It was assigned to this individual provider in the NPPES registry on June 12, 2006.

Where is Rya Kaplan located?

Rya Kaplan practices at 874 Whipple Rd Ste 100, Mount Pleasant, SC 29464. The listed phone number is (843) 606-4025.

What is Rya Kaplan's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Gastroenterology, with taxonomy code 207RG0100X.

Is Rya Kaplan enrolled in Medicare?

Yes. Rya Kaplan is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Rya Kaplan accept?

Health plans from Ambetter from Absolute Total Care, Ambetter of North Carolina, BlueCross BlueShield of South Carolina, First Choice Next and Molina Healthcare and 1 other insurer list Rya Kaplan 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.

Is Rya Kaplan affiliated with any hospitals?

According to CMS data, Rya Kaplan is affiliated with Musc Medical Center.

When was this NPI record last updated?

The NPPES record for Rya Kaplan was last updated on January 6, 2022. 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.