DR. SAMUEL JAY PERETSMAN M.D.
NPI 1912946336
Urology in Charlotte, NC

Q: What is Samuel Peretsman's NPI number?

The NPI number for Samuel Peretsman is 1912946336. It was assigned to this individual provider in the NPPES registry on June 5, 2006.

Q: What is Samuel Peretsman's specialty?

The primary specialty registered for this NPI is Urology with taxonomy code 208800000X.

Q: When was this NPI record last updated?

The NPPES record for Samuel Peretsman was last updated on May 30, 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.

Active since June 05, 2006PECOS EnrolledAccepts Medicare Assignment

201 QUEENS RD, CHARLOTTE, NC 28204(704) 372-5180(704) 376-6280 Get Directions Write a Review

NPPES record last updated: May 30, 2023. Verified against the NPPES registry weekly; last sync: October 25, 2026.

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About Dr. Samuel Jay Peretsman M.d. NPPES

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

DR. SAMUEL JAY PERETSMAN M.D. (NPI 1912946336) is an individual urology provider in Charlotte, North Carolina, licensed in North Carolina (9500688) and active in the NPI registry since June 2006. He is enrolled in Medicare PECOS, is affiliated with Mcleod Regional Medical Center-pee Dee, and maintains a secondary practice location in Columbia.

NPPES Registry Identity

NPI1912946336

Entity TypeIndividualMale

Primary Taxonomy208800000X

Provider Legal NameDR. SAMUEL JAY PERETSMANCredential: M.D.

Location Address201 QUEENS RDCharlotte, NC 28204-3217

Mailing AddressPo Box 36488Charlotte, NC 28236-6488 · (704) 248-3400 · Fax (704) 337-8387

Phone(704) 372-5180

Fax(704) 376-6280

Sole ProprietorNo

Medical School CMSBoston University School Of MedicineGraduated 1983

Enumeration DateJune 5, 2006

Last NPPES UpdateMay 30, 2023

NPPES CertifiedMay 30, 2023

✔ NPI 1912946336 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyUrologyAllopathic & Osteopathic Physicians

Taxonomy Code208800000X

Licenses✔ Licensed in NC · 9500688✔ Licensed in SC · 89031

Definition

A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures.

201 QUEENS RD, Charlotte, NC 28204

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Secondary Practice Location 1

Location 11301 Taylor St Ste 1AColumbia, SC 29201-2946 · Phone (803) 434-4790 · Fax (803) 434-4799

Other Identifiers 3

Other10465NC · Partners Provider #

Other66833NC · Bcbs Indi Provider #

Other340016821NC · Railroad Medicare Indi #

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

Dr. Samuel Jay Peretsman 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 ID5092749093

PECOS Enrollment IDI20230616002754

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

Medicare enrollment records show Samuel Peretsman reassigns Medicare billing to 4 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Carolinas Medical Center

0.4 mi

General Practice

2001 VAIL AVE
Charlotte, NC 28207

Reassigned Medicare billing, North Carolina enrollment
2,223 clinicians in this Medicare group

NPI 1326110909 (704) 355-2000

Stone Institute Of The Carolinas LLC

20 mi

Urology

215 SOUTH MAIN STREET, SU 201
Davidson, NC 28036

Reassigned Medicare billing, North Carolina enrollment
60 clinicians in this Medicare group

NPI 1457377954 (800) 822-5525

Prisma Health Medical Group-Midlands

80 mi

Interventional Cardiology

300 PALMETTO HEALTH PKWY STE 400
Columbia, SC 29212

Reassigned Medicare billing, South Carolina enrollment
1,466 clinicians in this Medicare group

NPI 1003307166 (803) 765-0871

Mcleod Regional Medical Center Of The Pee Dee, Inc

93 mi

Emergency Medical Services

555 E CHEVES ST
Florence, SC 29506

Reassigned Medicare billing, South Carolina enrollment
816 clinicians in this Medicare group

NPI 1154371433 (843) 777-2000

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 3

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.

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232

Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.

24 services14 patients

Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes 99222

Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.

18 services16 patients

Subsequent hospital care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes 99231

Follow-up hospital inpatient care is a daily service where a healthcare professional checks on your health progress during your hospital stay. Each session typically lasts 15 minutes, involving updates on your condition and adjustments to your treatment plan, if necessary.

18 services12 patients

Hospital Affiliations CMS Care Compare

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

Mcleod Regional Medical Center-Pee Dee

Acute Care Hospitals · Florence, SC

2/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number420051

Location555 E Cheves St Box 8700Florence, SC 29506 · Florence County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 28204 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

$125.01 typical visit price

range $54.12 – $165.09

Typical copayment $31.25 (range $13.53 – $41.27)

Most-billed visit code 99204

Established Patient

$67.72 typical visit price

range $17.21 – $134.61

Typical copayment $16.93 (range $4.30 – $33.65)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Referred Medical Equipment & Supplies CMS DME claims 6

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Intermittent urinary catheter; straight tip, with or without coating (teflon, silicone, silicone elastomer, or hydrophilic, etc.), each A4351

DME-Orthotic Devices · category DF008N

6 suppliers43 claims7,170 services$1.52 avg. paid by Medicare

Intermittent urinary catheter; coude (curved) tip, with or without coating (teflon, silicone, silicone elastomeric, or hydrophilic, etc.), each A4352

DME-Orthotic Devices · category DF008N

6 suppliers32 claims9,180 services$5.81 avg. paid by Medicare

Intermittent urinary catheter, with insertion supplies A4353

DME-Orthotic Devices · category DF008N

1 supplier12 claims2,400 services$6.69 avg. paid by Medicare

Bedside drainage bag, day or night, with or without anti-reflux device, with or without tube, each A4357

DME-Orthotic Devices · category DF000N

5 suppliers31 claims75 services$8.39 avg. paid by Medicare

Ostomy pouch, urinary; for use on barrier with non-locking flange, with faucet-type tap with valve (2 piece), each A4432

DME-Orthotic Devices · category DF010N

2 suppliers16 claims750 services$3.33 avg. paid by Medicare

Skin barrier, wipes or swabs, each A5120

DME-Orthotic Devices · category DF010N

2 suppliers16 claims980 services$0.22 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

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.

NOVANT HEALTH MEDICAL GROUP, LLC

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