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SOPHIA STEPHANIE URBAN MD
NPI 1790278703
Internal Medicine in Charleston, SC

Active since June 13, 2018PECOS EnrolledAccepts Medicare Assignment
73.84/100
CMS Quality Rating
165 ASHLEY AVE # MSC917, CHARLESTON, SC 29425(843) 792-0435 Get Directions Write a Review

NPPES record last updated: June 13, 2018. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Sophia Stephanie Urban Md NPPES

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

SOPHIA STEPHANIE URBAN MD (NPI 1790278703) is an individual internal medicine provider in Charleston, South Carolina, licensed in South Carolina (LL52653) and active in the NPI registry since June 2018. She is enrolled in Medicare PECOS, is affiliated with Musc Medical Center, and is a graduate of Eastern Virginia Medical School (2018).

NPPES Registry Identity

NPI1790278703
Entity TypeIndividualFemale
Primary Taxonomy207R00000X
Provider Legal NameSOPHIA STEPHANIE URBANCredential: MD
Location Address165 ASHLEY AVE # MSC917Charleston, SC 29425-8905
Mailing Address165 Ashley Ave # Msc917Charleston, SC 29425-8905
Phone(843) 792-0435
Sole ProprietorNo
Medical School CMSEastern Virginia Medical SchoolGraduated 2018
Enumeration DateJune 13, 2018
✔ NPI 1790278703 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License✔ Licensed in SC · LL52653
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.
165 ASHLEY AVE # MSC917, Charleston, SC 29425
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Absolute Total Care, Ambetter of North Carolina, BlueCross BlueShield of South Carolina 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 and accepts Medicare assignment

Sophia Stephanie Urban 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 ID5991058695
PECOS Enrollment IDI20230921002054
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 6

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 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.
48 services31 patients
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.
46 services26 patients
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.
35 services21 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.
24 services16 patients
Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes 99233
Follow-up hospital inpatient care per day typically involves a 35-minute check-up by your healthcare provider. This service includes monitoring your health progress, adjusting your treatment plan if needed, and answering any questions you may have about your condition or care.
16 services13 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.
15 services15 patients

Hospital Affiliations CMS Care Compare

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

Musc Medical Center

Acute Care Hospitals · Charleston, SC
2/5 CMS rating
OwnershipGovernment - Hospital District or Authority
CMS Certification Number420004
Location169 Ashley AveCharleston, SC 29425 · Charleston 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.

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.

73.84/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality60.28
Promoting Interoperability99
Improvement Activities40
Cost53.36

Other Providers at the Same Location NPPES 2

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

KRISTEN PUNSHON KYLER DO
Pediatrics
165 ASHLEY AVE # MSC917
CHARLESTON, SC 29425
Charleston County (843) 792-8972
SUSAN REED DDS, MPH, DRPH
Dentist (Dental Public Health)
165 ASHLEY AVE # MSC917, MEDICAL UNIVERSITY OF SOUTH CAROLINA
CHARLESTON, SC 29425
Charleston County (843) 792-1577

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 Sophia Urban's NPI number?

The NPI number for Sophia Urban is 1790278703. It was assigned to this individual provider in the NPPES registry on June 13, 2018.

Where is Sophia Urban located?

Sophia Urban practices at 165 Ashley Ave # Msc917, Charleston, SC 29425. The listed phone number is (843) 792-0435.

What is Sophia Urban's specialty?

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

Is Sophia Urban enrolled in Medicare?

Yes. Sophia Urban 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 Sophia Urban accept?

Health plans from Ambetter from Absolute Total Care, Ambetter of North Carolina, BlueCross BlueShield of South Carolina and Molina Healthcare list Sophia Urban 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 Sophia Urban affiliated with any hospitals?

According to CMS data, Sophia Urban is affiliated with Musc Medical Center.

When was this NPI record last updated?

The NPPES record for Sophia Urban was last updated on June 13, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 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.