CENTERWELL SENIOR PRIMARY CARE-DECKER BLVD
NPI 1356040992
Internal Medicine in Columbia, SC
About Centerwell Senior Primary Care-decker Blvd NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
CENTERWELL SENIOR PRIMARY CARE-DECKER BLVD (NPI 1356040992) is a healthcare organization registered as an internal medicine in Columbia, South Carolina and active in the NPI registry since March 2023. The organization holds a CLIA Waiver certificate valid through May 3, 2027 and lists Angie Martinez, Senior Credentialing Professional, as its authorized official.
NPPES Registry Identity
Specialties & Licenses 3
Other Names 1
Group Practice 1
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Centerwell Senior Primary Care-decker Blvd is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
34Medicare enrollment records show 34 clinicians reassign Medicare billing to Centerwell Senior Primary Care-Decker Blvd, which bills Medicare for the services they deliver. Of these, 10 practice within 10 miles. Listed here are the 20 practicing nearest to this location.
Clinicians by Medicare Specialty 4
Nearest to this location (20)
See all 34Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
CLIA Laboratory Certificates CMS CLIA
Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.
Certificate of Waiver 42D2281256
Centerwell Senior Primary Care-Decker Blvd · Columbia, SCFrequently 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 Centerwell Senior Primary Care Sc Jv PC's NPI number?
The NPI number for Centerwell Senior Primary Care Sc Jv PC is 1356040992. It was assigned to this organization in the NPPES registry on March 2, 2023. The provider is doing business as Centerwell Senior Primary Care-Decker Blvd.
Where is Centerwell Senior Primary Care Sc Jv PC located?
Centerwell Senior Primary Care Sc Jv PC is located at 2738 Decker Blvd Ste A, Columbia, SC 29206. The listed phone number is (803) 969-0543.
What is Centerwell Senior Primary Care Sc Jv PC's specialty?
The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.
Is Centerwell Senior Primary Care Sc Jv PC enrolled in Medicare?
Yes. Centerwell Senior Primary Care Sc Jv PC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Centerwell Senior Primary Care Sc Jv PC?
According to the CMS Revalidation Reassignment List (October 2026 release), 34 clinicians in 4 Medicare specialties reassign their Medicare billing to Centerwell Senior Primary Care Sc Jv PC. 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 Nurse Practitioner (14), Family Practice (9) and Cardiovascular Disease (Cardiology) (6). Of these, 10 practice within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Centerwell Senior Primary Care Sc Jv PC hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 42D2281256) is associated with this NPI, valid through May 3, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
When was this NPI record last updated?
The NPPES record for Centerwell Senior Primary Care Sc Jv PC was last updated on August 19, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.
# Centerwell Senior Primary Care-Decker Blvd · NPI 1356040992
Internal Medicine organization in Columbia, South Carolina. Organization record, active in the CMS NPPES registry since March 2, 2023.
## Identity
- **NPI:** 1356040992 (Entity type: Organization)
- **Enumerated:** March 2, 2023
- **Primary specialty:** Internal Medicine · taxonomy 207R00000X
- **Legal business name:** Centerwell Senior Primary Care Sc Jv Pc
- **Organization subpart:** Yes (part of Centerwell Senior Primary Care Sc Jv Pc)
- **Authorized official:** Angie Martinez, SENIOR CREDENTIALING PROFESSIONAL
## Practice location
- **Address:** 2738 DECKER BLVD STE A, Columbia, SC 29206-1735
- **Phone:** (803) 969-0543 · **Fax:** (877) 958-9029
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 34 clinicians in 4 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Nurse Practitioner (14), Family Practice (9), Cardiovascular Disease (Cardiology) (6); 10 practice within 10 miles; [full list](https://npiprofile.com/npi/1356040992/clinicians) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** August 19, 2024
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1356040992) · Data from the CMS NPPES public registry.