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KARAN PRASHANT PANDYA MD
NPI 1417487026
Internal Medicine in Charleston, SC

Active since June 15, 2017PECOS EnrolledAccepts Medicare Assignment
169 ASHLEY AVENUE, ROOM 202 MAIN HOSPITAL MSC333, CHARLESTON, SC 29425(843) 792-4074 Get Directions Write a Review

NPPES record last updated: July 31, 2023. Verified against the NPPES registry weekly; last sync: October 11, 2026.

Record update history: Jul 21, 2022, Jun 15, 2017 (2 updates tracked since 2017).

About Karan Prashant Pandya Md NPPES

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

KARAN PRASHANT PANDYA MD (NPI 1417487026) is an individual internal medicine provider in Charleston, South Carolina, licensed in South Carolina (LL51185) and active in the NPI registry since June 2017. He is enrolled in Medicare PECOS, is affiliated with Unc Hospitals, and maintains a secondary practice location in Raleigh.

NPPES Registry Identity

NPI1417487026
Entity TypeIndividualMale
Primary Taxonomy207R00000X
Provider Legal NameKARAN PRASHANT PANDYACredential: MD
Location Address169 ASHLEY AVENUE, ROOM 202 MAIN HOSPITAL MSC333Charleston, SC 29425
Mailing Address169 Ashley Ave Rm 202Charleston, SC 29425-8905 · (843) 792-4074
Phone(843) 792-4074
Sole ProprietorNo
Medical School CMSWake Forest University School Of MedicineGraduated 2017
Enumeration DateJune 15, 2017
Last NPPES UpdateJuly 31, 20232 updates tracked since enumeration
NPPES CertifiedJuly 31, 2023
✔ NPI 1417487026 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 · LL51185
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 ListedInternal Medicine · Hematology & OncologyTaxonomy 207RH0003X · License 2023-01607 (NC)
169 ASHLEY AVENUE, Charleston, SC 29425
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Secondary Practice Location 1

Location 111200 Governor Manly Way Ste 102Raleigh, NC 27614-7360 · Phone (919) 570-7550

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of NC, UnitedHealthcare.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

Karan Prashant Pandya 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 ID1850666108
PECOS Enrollment IDI20230808003661
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 4

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 high level of medical decision making, if using time, 40 minutes or more 99215
This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.
157 services44 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.
89 services56 patients
New patient office or other outpatient visit with a high level of medical decision making, if using time, 60 minutes or more 99205
This is a first-time patient visit where a healthcare professional spends 60-74 minutes with you. It involves a comprehensive evaluation, including your medical history and current health condition. They'll also advise on preventive health measures and formulate a treatment plan if needed.
80 services80 patients
Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes 99223
Initial hospital inpatient care per day, typically 70 minutes, refers to the daily medical service provided to patients admitted to the hospital. This includes a comprehensive evaluation, diagnosis, treatment plan, and monitoring of your health condition. It ensures your well-being during your hospital stay.
21 services21 patients

Hospital Affiliations CMS Care Compare 2

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

Unc Hospitals

Acute Care Hospitals · Chapel Hill, NC
5/5 CMS rating
OwnershipGovernment - State
CMS Certification Number340061
Location101 Manning DriveChapel Hill, NC 27514 · Orange County
Emergency services Birthing friendly

Rex Hospital

Acute Care Hospitals · Raleigh, NC
5/5 CMS rating
OwnershipGovernment - State
CMS Certification Number340114
Location4420 Lake Boone TrailRaleigh, NC 27607 · Wake County
Emergency services Birthing friendly

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.

DR. JAMES HOWARD BENSON III MD
Internal Medicine
169 ASHLEY AVENUE, ROOM 202 MAIN HOSPITAL MSC333
CHARLESTON, SC 29425
Charleston County (843) 792-4074
COURTNEY AUGUSTA LUKITSCH MD
Psychiatry & Neurology (Psychiatry)
169 ASHLEY AVENUE, ROOM 202 MAIN HOSPITAL, MSC333
CHARLESTON, SC 29425
Charleston County (843) 792-9162
DR. CHARLES SPENCER TEIXEIRA DO
Internal Medicine (Infectious Disease)
169 ASHLEY AVENUE, ROOM 202 MAIN HOSPITAL MSC 333
CHARLESTON, SC 29425
Charleston County (843) 792-2575
CHELSEA WRIGHT-VOID MD
Pathology (Anatomic Pathology & Clinical Pathology)
169 ASHLEY AVENUE, ROOM 202 MAIN HOSPITAL MSC333
CHARLESTON, SC 29425
Charleston County (843) 792-1086
HELEN JENSIE BURTON MD
Internal Medicine
169 ASHLEY AVENUE, ROOM 202 MSC333
CHARLESTON, SC 29425
Charleston County (843) 792-2911
DR. MITCHELL BENTON MD
Internal Medicine
169 ASHLEY AVENUE, ROOM 202 MAIN HOSPITAL MSC333
CHARLESTON, SC 29425
Charleston County (843) 792-5386
DR. ALLISON CRECELIUS DO
Emergency Medicine
169 ASHLEY AVENUE, ROOM 202 MAIN HOSPITAL MSC333
CHARLESTON, SC 29425
Charleston County (314) 808-5444
RONIT KULKARNI
Surgery
169 ASHLEY AVENUE, ROOM 202 MAIN HOSPITAL MSC333
CHARLESTON, SC 29425
Charleston County (843) 792-2081

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 Karan Pandya's NPI number?

The NPI number for Karan Pandya is 1417487026. It was assigned to this individual provider in the NPPES registry on June 15, 2017.

Where is Karan Pandya located?

Karan Pandya practices at 169 Ashley Avenue Room 202 Main Hospital Msc333, Charleston, SC 29425. The listed phone number is (843) 792-4074.

What is Karan Pandya's specialty?

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

Is Karan Pandya enrolled in Medicare?

Yes. Karan Pandya 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 Karan Pandya accept?

Health plans from Blue Cross and Blue Shield of NC and UnitedHealthcare list Karan Pandya 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 Karan Pandya affiliated with any hospitals?

According to CMS data, Karan Pandya is affiliated with Unc Hospitals and Rex Hospital.

When was this NPI record last updated?

The NPPES record for Karan Pandya was last updated on July 31, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.