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PAYAM YOUSEFIAN M.D.
NPI 1477749620
Family Medicine in Lexington, SC

Active since September 21, 2007PECOS EnrolledAccepts Medicare Assignment
70.05/100
CMS Quality Rating
5224 SUNSET BLVD, LEXINGTON, SC 29072(803) 796-4251(803) 796-4449 Get Directions Write a Review

NPPES record last updated: December 15, 2025. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Dec 15, 2025, Nov 11, 2024, Oct 25, 2018 (3 updates tracked since 2018).

About Payam Yousefian M.d. NPPES

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

PAYAM YOUSEFIAN M.D. (NPI 1477749620) is an individual family medicine provider in Lexington, South Carolina, licensed in South Carolina (32197) and active in the NPI registry since September 2007. He is enrolled in Medicare PECOS, maintains 2 additional practice locations, and is a graduate of Other (2006).

NPPES Registry Identity

NPI1477749620
Entity TypeIndividualMale
Primary Taxonomy207Q00000X
Provider Legal NamePAYAM YOUSEFIANCredential: M.D.
Location Address5224 SUNSET BLVDLexington, SC 29072-9259
Mailing AddressPo Box 749306Atlanta, GA 30374-9306
Phone(803) 796-4251
Fax(803) 796-4449
Sole ProprietorNo
Medical School CMSOtherGraduated 2006
Enumeration DateSeptember 21, 2007
Last NPPES UpdateDecember 15, 20253 updates tracked since enumeration
NPPES CertifiedDecember 15, 2025
✔ NPI 1477749620 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in SC · 32197
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
5224 SUNSET BLVD, Lexington, SC 29072
Open in Google Maps ↗

Secondary Practice Locations 2

Location 11085 Dutch Fork RdIrmo, SC 29063-8725 · Phone (803) 971-5410 · Fax (803) 971-5415
Location 2100 Palmetto Health Pkwy Ste 104Columbia, SC 29212-1754 · Phone (803) 999-1214 · Fax (803) 999-1215

Accepted Insurance

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

Payam Yousefian 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 ID1254464852
PECOS Enrollment IDI20100803000956
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

2

Medicare enrollment records show Payam Yousefian reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Prisma Health Urgent Care Of South Carolina, PC
85 mi
Urgent Care
905 VERDAE BLVD STE 101
Greenville, SC 29607
  • Reassigned Medicare billing, South Carolina enrollment
  • 160 clinicians in this Medicare group
NPI 1851000855 (864) 990-1910
Novant Health Urgent Cares LLC
90 mi
Urgent Care
2126 HIGHWAY 81 N
Anderson, SC 29621
  • Reassigned Medicare billing, South Carolina enrollment
  • 133 clinicians in this Medicare group
NPI 1841026382 (999) 999-9999

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 7

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 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.
58 services42 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.
42 services35 patients
Amplifed dna or rna probe detection of severe acute respiratory syndrome coronavirus 2 (covid-19) antigen 87635
This is a lab test that detects the presence of COVID-19 in your body. It uses a technique to amplify the virus's genetic material, either DNA or RNA, making it easier to identify. A positive result indicates an active infection.
32 services28 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.
31 services31 patients
Detection test by nucleic acid for multiple types influenza virus 87502
A detection test by nucleic acid for multiple types of influenza virus is a diagnostic procedure. It identifies the genetic material of the virus in your body. It's highly accurate and can distinguish between different flu strains, helping in prompt and precise treatment.
24 services22 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.
22 services22 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 29072 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.

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.

70.05/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality48.22
Promoting Interoperability98
Improvement Activities40
Cost53.62

Reported Quality Measures

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…
100%344 patients5/55-star benchmark: 100%
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.

Other Providers at the Same Location NPPES 3

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

DOCTORS CARE SC, PA
Family Medicine
5224 SUNSET BLVD
LEXINGTON, SC 29072
Lexington County (803) 796-4251
GERRI A KUKUCKA NP
Nurse Practitioner (Family)
5224 SUNSET BLVD
LEXINGTON, SC 29072
Lexington County (803) 796-4251
DAVID PEREZ PA
Physician Assistant
5224 SUNSET BLVD
LEXINGTON, SC 29072
Lexington County (803) 796-4449

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 Payam Yousefian's NPI number?

The NPI number for Payam Yousefian is 1477749620. It was assigned to this individual provider in the NPPES registry on September 21, 2007.

Where is Payam Yousefian located?

Payam Yousefian practices at 5224 Sunset Blvd, Lexington, SC 29072. The listed phone number is (803) 796-4251.

What is Payam Yousefian's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Payam Yousefian enrolled in Medicare?

Yes. Payam Yousefian 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.

Which organizations bill Medicare for Payam Yousefian's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Payam Yousefian reassigns Medicare benefits to 2 organizations: Prisma Health Urgent Care Of South Carolina, PC (Greenville, SC) and Novant Health Urgent Cares LLC (Anderson, SC). Each 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 Payam Yousefian's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Payam Yousefian accept?

Health plans from Ambetter Health, Ambetter from Absolute Total Care, Ambetter of North Carolina and First Choice Next list Payam Yousefian 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.

When was this NPI record last updated?

The NPPES record for Payam Yousefian was last updated on December 15, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 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.