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ANDREW J. MCMARLIN D.O.
NPI 1497719355
Family Medicine - Sports Medicine in Mount Pleasant, SC

Active since April 16, 2006PECOS Enrolled
966 HOUSTON NORTHCUTT BLVD STE E, MOUNT PLEASANT, SC 29464(843) 471-0375 Get Directions Write a Review

NPPES record last updated: March 13, 2020. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Andrew J. Mcmarlin D.o. NPPES

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

ANDREW J. MCMARLIN D.O. (NPI 1497719355) is an individual sports medicine provider in Mount Pleasant, South Carolina, licensed in South Carolina (1530) and active in the NPI registry since April 2006. He is enrolled in Medicare PECOS, is affiliated with Trident Medical Center, and is a graduate of Philadelphia College Of Osteopathic Medicine (2003).

NPPES Registry Identity

NPI1497719355
Entity TypeIndividualMale
Primary Taxonomy207QS0010X
Provider Legal NameANDREW J. MCMARLINCredential: D.O.
Location Address966 HOUSTON NORTHCUTT BLVD STE EMount Pleasant, SC 29464-3487
Mailing Address966 Houston Northcutt Blvd Ste EMount Pleasant, SC 29464-3487 · (843) 471-0375
Phone(843) 471-0375
Sole ProprietorYes
Medical School CMSPhiladelphia College Of Osteopathic MedicineGraduated 2003
Enumeration DateApril 16, 2006
Last NPPES UpdateMarch 13, 2020
NPPES CertifiedMarch 13, 2020
✔ NPI 1497719355 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyFamily Medicine · Sports MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207QS0010X
License✔ Licensed in SC · 1530
Definition
A family medicine physician that is trained to be responsible for continuous care in the field of sports medicine, not only for the enhancement of health and fitness, but also for the prevention of injury and illness. A sports medicine physician must have knowledge and experience in the promotion of wellness and the prevention of injury. Knowledge about special areas of medicine such as exercise physiology, biomechanics, nutrition, psychology, physical rehabilitation, epidemiology, physical evaluation, injuries (treatment and prevention and referral practice) and the role of exercise in promoting a healthy lifestyle are essential to the practice of sports medicine. The sports medicine physician requires special education to provide the knowledge to improve the health care of the individual engaged in physical exercise (sports) whether as an individual or in team participation.
Also ListedFamily MedicineTaxonomy 207Q00000X · License 1530 (SC)
966 HOUSTON NORTHCUTT BLVD STE E, Mount Pleasant, SC 29464
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Other Identifiers 1

Medicaid015307SC

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include BlueCross BlueShield of South Carolina, First Choice Next, Molina Healthcare 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 (PECOS)

Andrew J. Mcmarlin D.o. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID1951307636
PECOS Enrollment IDI20111227000195
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 12

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.

Hyaluronan or derivative, durolane, for intra-articular injection, 1 mg J7318
Hyaluronan or derivative, Durolane, is a treatment injected directly into the joint to relieve pain and improve mobility. It's often used for arthritis in the knee. The substance works by supplementing your body's natural joint fluid to help lubricate and cushion the joint.
1,680 services19 patients
Injection, triamcinolone acetonide, not otherwise specified, 10 mg J3301
Triamcinolone acetonide is a medication used to reduce inflammation in the body. It's given as a 10 mg injection for conditions like allergies, arthritis, or skin problems. The injection helps to decrease swelling, redness, and itching.
1,452 services108 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.
361 services120 patients
Aspiration and/or injection of fluid large joint using ultrasound guidance 20611
This procedure involves using ultrasound technology to accurately locate a large joint, usually the knee or shoulder. A needle is then inserted to either extract fluid (aspiration) or inject medication. The ultrasound helps ensure precision and safety.
150 services76 patients
Injection of lower or sacral spine facet joint using imaging guidance, single level 64493
This procedure involves injecting medication into the facet joint in your lower back or sacral spine. It's done under imaging guidance to ensure accuracy. The aim is to alleviate pain and inflammation. It's a safe, often effective method for managing spinal discomfort.
68 services53 patients
Injection of lower or sacral spine facet joint using imaging guidance, second level 64494
This procedure involves injecting medication into the facet joints of your lower or sacral spine to manage pain. Imaging guidance ensures accurate placement. It's the second level, meaning it's done on two different joint levels.
68 services53 patients

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

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
$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.

Reported Quality Measures

Care Plan
Percentage of patients aged 65 years and older who have an advance care plan or surrogate decision maker documented in the medical record that an advance care plan was discussed but the patient did not wish or was not able to name a surrogate decision maker…
99%132 patients4/55-star benchmark: 100%
Closing the Referral Loop: Receipt of Specialist Report
Percentage of patients with referrals, regardless of age, for which the referring provider receives a report from the provider to whom the patient was referred
12%354 patients1/55-star benchmark: 95%
Colorectal Cancer Screening
Percentage of adults 50-75 years of age who had appropriate screening for colorectal cancer
65%209 patients4/55-star benchmark: 85%
Documentation of Current Medications in the Medical Record
Percentage of visits for patients aged 18 years and older for which the eligible professional or eligible clinician attests to documenting a list of current medications using all immediate resources available on the date of the encounter.
97%1,488 patients4/55-star benchmark: 100%
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.
95%701 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…
80%489 patients4/55-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%618 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.
83%832 patients4/55-star benchmark: 97%
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…
78%555 patients4/55-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
29%580 patients2/55-star benchmark: 88%
Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention
Percentage of patients aged 18 years and older who were screened for tobacco use one or more times within 24 months AND who received tobacco cessation intervention if identified as a tobacco user
Patients screenedForUse: 100% · 477 patients
96%342 patients4/55-star benchmark: 98%
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%832 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…
88%832 patients4/55-star benchmark: 89%
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.
29%832 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.

Other Providers at the Same Location NPPES

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

JANA UPSHAW MD
Family Medicine (Sports Medicine)
966 HOUSTON NORTHCUTT BLVD STE E
MOUNT PLEASANT, SC 29464
Charleston County (843) 471-0375

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 Andrew Mcmarlin's NPI number?

The NPI number for Andrew Mcmarlin is 1497719355. It was assigned to this individual provider in the NPPES registry on April 16, 2006.

Where is Andrew Mcmarlin located?

Andrew Mcmarlin practices at 966 Houston Northcutt Blvd Ste E, Mount Pleasant, SC 29464. The listed phone number is (843) 471-0375.

What is Andrew Mcmarlin's specialty?

The primary specialty registered for this NPI is Family Medicine, specializing in Sports Medicine, with taxonomy code 207QS0010X.

Is Andrew Mcmarlin enrolled in Medicare?

Yes. Andrew Mcmarlin is registered in the Medicare PECOS enrollment system.

What insurance does Andrew Mcmarlin accept?

Health plans from BlueCross BlueShield of South Carolina, First Choice Next, Molina Healthcare and UnitedHealthcare list Andrew Mcmarlin 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 Andrew Mcmarlin affiliated with any hospitals?

According to CMS data, Andrew Mcmarlin is affiliated with Trident Medical Center.

When was this NPI record last updated?

The NPPES record for Andrew Mcmarlin was last updated on March 13, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.