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BRIAN GLENN WIDENHOUSE M.D.
NPI 1265481543
Surgery - Plastic and Reconstructive Surgery in North Charleston, SC

Active since May 06, 2006PECOS EnrolledAccepts Medicare Assignment
2683 LAKE PARK DR, NORTH CHARLESTON, SC 29406(843) 518-5000(843) 614-8959 Get Directions Write a Review

NPPES record last updated: April 3, 2017. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Brian Glenn Widenhouse M.d. NPPES

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

BRIAN GLENN WIDENHOUSE M.D. (NPI 1265481543) is an individual plastic and reconstructive surgery provider in North Charleston, South Carolina, licensed in South Carolina (20096) and active in the NPI registry since May 2006. He is enrolled in Medicare PECOS, is affiliated with Trident Medical Center, and is a graduate of Brody School Of Medicine At East Carolina University (1991).

NPPES Registry Identity

NPI1265481543
Entity TypeIndividualMale
Primary Taxonomy2086S0122X
Provider Legal NameBRIAN GLENN WIDENHOUSECredential: M.D.
Location Address2683 LAKE PARK DRNorth Charleston, SC 29406-9100
Mailing Address2683 Lake Park DrNorth Charleston, SC 29406-9100 · (843) 518-5000 · Fax (843) 614-8959
Phone(843) 518-5000
Fax(843) 614-8959
Sole ProprietorNo
Medical School CMSBrody School Of Medicine At East Carolina UniversityGraduated 1991
Enumeration DateMay 6, 2006
Last NPPES UpdateApril 3, 2017
✔ NPI 1265481543 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySurgery · Plastic and Reconstructive SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code2086S0122X
License✔ Licensed in SC · 20096
Definition
A surgeon who specializes in plastic and reconstructive surgery.
2683 LAKE PARK DR, North Charleston, SC 29406
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Other Identifiers 3

Medicare UPING68767SC
Medicaid200963SC
Medicare PING687670281SC

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.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

Brian Glenn Widenhouse M.d. 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 ID8628054152
PECOS Enrollment IDI20040625000817
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.

Hospital Affiliations CMS Care Compare

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

Trident Medical Center

Acute Care Hospitals · Charleston, SC
3/5 CMS rating
OwnershipProprietary
CMS Certification Number420079
Location9330 Medical Plaza DrCharleston, SC 29406 · Charleston County
Emergency services Birthing friendly

Other Providers at the Same Location NPPES 2

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

WILLIAM A TERRANOVA MD
Plastic Surgery
2683 LAKE PARK DR
NORTH CHARLESTON, SC 29406
Charleston County (843) 797-0440
PORT CITY PLASTIC SURGERY, LLC
Surgery (Plastic and Reconstructive Surgery)
2683 LAKE PARK DR
NORTH CHARLESTON, SC 29406
Charleston County (843) 518-5000

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 Brian Widenhouse's NPI number?

The NPI number for Brian Widenhouse is 1265481543. It was assigned to this individual provider in the NPPES registry on May 6, 2006.

Where is Brian Widenhouse located?

Brian Widenhouse practices at 2683 Lake Park Dr, North Charleston, SC 29406. The listed phone number is (843) 518-5000.

What is Brian Widenhouse's specialty?

The primary specialty registered for this NPI is Surgery, specializing in Plastic and Reconstructive Surgery, with taxonomy code 2086S0122X.

Is Brian Widenhouse enrolled in Medicare?

Yes. Brian Widenhouse 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 Brian Widenhouse accept?

Health plans from Ambetter from Absolute Total Care, Ambetter of North Carolina and BlueCross BlueShield of South Carolina list Brian Widenhouse 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 Brian Widenhouse affiliated with any hospitals?

According to CMS data, Brian Widenhouse is affiliated with Trident Medical Center.

When was this NPI record last updated?

The NPPES record for Brian Widenhouse was last updated on April 3, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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.