PRIVATE PHYSICIAN GROUP LLC
NPI 1639841323
Family Medicine in Fort Mill, SC
About Private Physician Group Llc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
PRIVATE PHYSICIAN GROUP LLC (NPI 1639841323) is a healthcare organization registered as a family medicine in Fort Mill, South Carolina and active in the NPI registry since September 2021. The organization lists Catherine L. Ferrara, Owner, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Group Practice 1
Medicare Participation & PECOS CMS
Medicare enrollment, revalidation and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Private Physician Group Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Revalidation Due Date
Revalidation due by December 31, 2026
Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.
Clinicians Billing Medicare Through This Organization
2Medicare enrollment records show 2 clinicians reassign Medicare billing to Private Physician Group LLC, which bills Medicare for the services they deliver. They are listed nearest first.
Clinicians, nearest first (2)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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 Private Physician Group LLC's NPI number?
The NPI number for Private Physician Group LLC is 1639841323. It was assigned to this organization in the NPPES registry on September 30, 2021.
Where is Private Physician Group LLC located?
Private Physician Group LLC is located at 1698 Highway 160 W Ste 200, Fort Mill, SC 29708. The listed phone number is (516) 590-4475.
What is Private Physician Group LLC's specialty?
The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.
Is Private Physician Group LLC enrolled in Medicare?
Yes. Private Physician Group LLC is registered in the Medicare PECOS enrollment system.
When is Private Physician Group LLC's Medicare revalidation due?
According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (North Carolina, Clinic/Group Practice) is due for revalidation by December 31, 2026. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.
How many clinicians bill Medicare through Private Physician Group LLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 2 clinicians, all in Family Practice, reassign their Medicare billing to Private Physician Group LLC. 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. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
When was this NPI record last updated?
The NPPES record for Private Physician Group LLC was last updated on September 30, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.
# Private Physician Group Llc · NPI 1639841323
Family Medicine organization in Fort Mill, South Carolina. Organization record, active in the CMS NPPES registry since September 30, 2021.
## Identity
- **NPI:** 1639841323 (Entity type: Organization)
- **Enumerated:** September 30, 2021
- **Primary specialty:** Family Medicine · taxonomy 207Q00000X
- **Organization subpart:** No
- **Authorized official:** Catherine Ferrara, OWNER
## Practice location
- **Address:** 1698 HIGHWAY 160 W STE 200, Fort Mill, SC 29708-8034
- **Phone:** (516) 590-4475 · **Fax:** (803) 267-8229
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Medicare revalidation due:** December 31, 2026 (Non-DME Part B, North Carolina, Clinic/Group Practice) · CMS Revalidation Due Date List, October 2026 release
- **Clinicians billing through this organization:** 2 clinicians (Family Practice) reassign Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** September 30, 2021
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Source: [NPI Profile](https://npiprofile.com/npi/1639841323) · Data from the CMS NPPES public registry.