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DR. DOUGLAS CHARLES SWARTZ M.D.
NPI 1992095236
Family Medicine in Pawleys Island, SC

Active since April 07, 2011PECOS EnrolledAccepts Medicare Assignment
9699 OCEAN HWY, PAWLEYS ISLAND, SC 29585(843) 237-4296(843) 237-0495 Get Directions Write a Review

NPPES record last updated: January 14, 2016. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Dr. Douglas Charles Swartz M.d. NPPES

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

DR. DOUGLAS CHARLES SWARTZ M.D. (NPI 1992095236) is an individual family medicine provider in Pawleys Island, South Carolina, licensed in South Carolina (33573) and active in the NPI registry since April 2011. He is enrolled in Medicare PECOS, is affiliated with Hilton Head Regional Medical Center, and is a graduate of Other (2013).

NPPES Registry Identity

NPI1992095236
Entity TypeIndividualMale
Primary Taxonomy207Q00000X
Provider Legal NameDR. DOUGLAS CHARLES SWARTZCredential: M.D.
Location Address9699 OCEAN HWYPawleys Island, SC 29585-7425
Mailing AddressPo Box 1209Murrells Inlet, SC 29576-1209 · (843) 652-8220 · Fax (843) 527-7080
Phone(843) 237-4296
Fax(843) 237-0495
Sole ProprietorNo
Medical School CMSOtherGraduated 2013
Enumeration DateApril 7, 2011
Last NPPES UpdateJanuary 14, 2016
✔ NPI 1992095236 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in SC · 33573
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.
Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X
9699 OCEAN HWY, Pawleys Island, SC 29585
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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 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. Douglas Charles Swartz 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 ID5193963601
PECOS Enrollment IDI20141208000592
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

4

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

Southeastern Hospitalist Services PC
29 mi
Hospitalist
809 82ND PKWY
Myrtle Beach, SC 29572
  • Reassigned Medicare billing, South Carolina enrollment
  • 529 clinicians in this Medicare group
NPI 1003280108 (843) 692-1000
Mcleod Physician Associates II
63 mi
Urology
800 E CHEVES ST, SUITE 350
Florence, SC 29506
  • Reassigned Medicare billing, South Carolina enrollment
  • 878 clinicians in this Medicare group
NPI 1649428194 (843) 665-2000
Hilton Head Regional Physician Group LLC
113 mi
Orthopaedic Surgery
97 SEA ISLAND PKWY STE 203
Beaufort, SC 29907
  • Reassigned Medicare billing, South Carolina enrollment
  • 157 clinicians in this Medicare group
NPI 1942011218 (843) 682-7480
Lowcountry Family Care LLC
124 mi
Health Service
460 WILLIAM HILTON PKWY STE E460
Hilton Head Island, SC 29926
  • Reassigned Medicare billing, South Carolina enrollment
  • 3 clinicians in this Medicare group
NPI 1881260784 (843) 816-7266

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 5

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.

Hospital discharge day management, more than 30 minutes 99239
Hospital discharge day management over 30 minutes involves a detailed process to ensure a smooth transition from hospital to home. It includes final examinations, discussion of your hospital stay, post-discharge instructions, and coordinating follow-up care.
264 services247 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.
243 services146 patients
Advance care planning, first 30 minutes 99497
Advance care planning is a process where you discuss your healthcare preferences with your doctor. This conversation, lasting up to 30 minutes, helps ensure your wishes are respected if you're unable to communicate them in the future. It's about your care, your way.
189 services173 patients
Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes 99223
Initial hospital inpatient care per day, typically 70 minutes, refers to the daily medical service provided to patients admitted to the hospital. This includes a comprehensive evaluation, diagnosis, treatment plan, and monitoring of your health condition. It ensures your well-being during your hospital stay.
141 services135 patients
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.
112 services81 patients

Hospital Affiliations CMS Care Compare 2

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

Hilton Head Regional Medical Center

Acute Care Hospitals · Hilton Head Island, SC
4/5 CMS rating
OwnershipVoluntary non-profit - Other
CMS Certification Number420080
Location25 Hospital Center BlvdHilton Head Island, SC 29925 · Beaufort County
Emergency services Birthing friendly

Coastal Carolina Hospital

Acute Care Hospitals · Hardeeville, SC
2/5 CMS rating
OwnershipProprietary
CMS Certification Number420101
Location1000 Medical Center DriveHardeeville, SC 29927 · Jasper County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 29585 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…
100%253 patients5/55-star benchmark: 100%
Coronary Artery Disease (CAD): Antiplatelet Therapy
Percentage of patients aged 18 years and older with a diagnosis of coronary artery disease (CAD) seen within a 12 month period who were prescribed aspirin or clopidogrel
91%23 patients4/55-star benchmark: 100%
Diabetes: Medical Attention for Nephropathy
The percentage of patients 18-75 years of age with diabetes who had a nephropathy screening test or evidence of nephropathy during the measurement period
82%66 patients4/55-star benchmark: 100%
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.
99%593 patients4/55-star benchmark: 100%
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…
96%462 patients4/55-star benchmark: 100%
Preventive Care and Screening: Unhealthy Alcohol Use: Screening & Brief Counseling
Percentage of patients aged 18 years and older who were screened for unhealthy alcohol use using a systematic screening method at least once within the last 24 months AND who received brief counseling if identified as an unhealthy alcohol user
87%98 patients4/55-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.

Referred Medical Equipment & Supplies CMS DME claims 4

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

Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing E0431
DME-Oxygen and Supplies · category DC000N
2 suppliers75 claims75 services$17.17 avg. paid by Medicare
Nebulizer, with compressor E0570
DME-Other DME · category DE000N
1 supplier16 claims16 services$6.04 avg. paid by Medicare
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390
DME-Oxygen and Supplies · category DC002N
2 suppliers87 claims87 services$88.52 avg. paid by Medicare
Portable oxygen concentrator, rental E1392
DME-Oxygen and Supplies · category DC002N
1 supplier12 claims12 services$28.34 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 18

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

MRS. JOANNA MAZURKIEWICZ CHAVEZ FNP-BC
Nurse Practitioner (Family)
9699 OCEAN HWY
PAWLEYS ISLAND, SC 29585
Georgetown County (843) 520-8729
KENT BRYCE LOADER JR. M.D.
Family Medicine
9699 OCEAN HWY
PAWLEYS ISLAND, SC 29585
Georgetown County (843) 237-4296
CYNTHIA RILEY
Nurse Practitioner
9699 OCEAN HWY
PAWLEYS ISLAND, SC 29585
Georgetown County (843) 237-4296
DR. RICHARD ANDREW PHILIPP II MD
Family Medicine
9699 OCEAN HWY
PAWLEYS ISLAND, SC 29585
Georgetown County (843) 237-4296
DR. MICHAEL BRITTON REMINES DO
Internal Medicine
9699 OCEAN HWY
PAWLEYS ISLAND, SC 29585
Georgetown County (843) 237-4296
EDWARD SCOTT BRUMFIELD MD
Family Medicine
9699 OCEAN HWY, GEORGETOWN HEALTH GROUP
PAWLEYS ISLAND, SC 29585
Georgetown County (843) 237-4296
COURTNEY STURGILL APRN
Nurse Practitioner (Family)
9699 OCEAN HWY
PAWLEYS ISLAND, SC 29585
Georgetown County (843) 237-4296
GEORGETOWN PHYSICIAN ASSOCIATES, LLC
Clinic/Center (Rural Health)
9699 OCEAN HWY
PAWLEYS ISLAND, SC 29585
Georgetown County (843) 237-4297

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 Douglas Swartz's NPI number?

The NPI number for Douglas Swartz is 1992095236. It was assigned to this individual provider in the NPPES registry on April 7, 2011.

Where is Douglas Swartz located?

Douglas Swartz practices at 9699 Ocean Hwy, Pawleys Island, SC 29585. The listed phone number is (843) 237-4296.

What is Douglas Swartz's specialty?

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

Is Douglas Swartz enrolled in Medicare?

Yes. Douglas Swartz 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 Douglas Swartz's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Douglas Swartz reassigns Medicare benefits to 4 organizations: Southeastern Hospitalist Services PC (Myrtle Beach, SC), Mcleod Physician Associates II (Florence, SC), Hilton Head Regional Physician Group LLC (Beaufort, SC) and Lowcountry Family Care LLC (Hilton Head Island, 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 Douglas Swartz's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Douglas Swartz accept?

Health plans from Ambetter Health, Ambetter from Absolute Total Care, Ambetter of North Carolina and First Choice Next list Douglas Swartz 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 Douglas Swartz affiliated with any hospitals?

According to CMS data, Douglas Swartz is affiliated with Hilton Head Regional Medical Center and Coastal Carolina Hospital.

When was this NPI record last updated?

The NPPES record for Douglas Swartz was last updated on January 14, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 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.