NPIMap

Individual provider Active NPI

Husam Mourtada, MD

  • Sports Medicine (Neuromusculoskeletal Medicine) Physician
  • Spartanburg, SC
National Provider Identifier
1114998671
Registry record updated Jan 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Neuromusculoskeletal Medicine) PhysicianTaxonomy code 204C00000X
License
26527 Issued in SC
Practice address
1330 Boiling Springs Rd
Suite 1800
Spartanburg, SC 29303-4201
Phone
(864) 560-9646
NPI assigned
Jan 31, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Neuromusculoskeletal Medicine) Physician 204C00000X 26527 SC Primary

Addresses

Primary practice location

1330 Boiling Springs Rd
Suite 1800
Spartanburg, SC 29303-4201

Mailing address

PO Box 743070
Atlanta, GA 30374-3070
Phone (864) 560-4304

Other identifiers 5

IdentifierTypeStateIssuer
265279MedicaidSC
067EJOtherNCBCBS
D1678OtherSCMEDCOST
7806056OtherSCAETNA
89067EJMedicaidNC

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address hmourtada8489@direct-srhs.et0939.epichosted.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040226000811 SC Practitioner - Physical Medicine and RehabilitationPractitioner - Interventional Pain Management 5193611093 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and RehabilitationAlso: Interventional Pain Management
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Spartanburg Medical CenterGroup PAC ID 3072425297, 1,060 clinicians
Pelham Medical CenterGroup PAC ID 2365519097, 132 clinicians

Practice addresses (Care Compare)

1330 Boiling Springs Rd
Suite 1800
Spartanburg, SC 29303-4209
Phone (864) 560-9646

250 Westmoreland Rd
Greer, SC 29651-9013
Phone (864) 560-6619

Hospital & facility affiliations

  • Pelham Medical Center Hospital, Greer, SC, CCN 420103
  • Spartanburg Medical Center Hospital, Spartanburg, SC, CCN 420007
  • Cherokee Medical Center Hospital, Gaffney, SC, CCN 420043

Merit-based Incentive Payment System (MIPS)

Final score
94.7 of 100Reported as apm
Quality
89.4
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
26527SCMDSports Medicine (Neuromusculoskeletal Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pelham Medical Center Neuromusculoskeletal Medicine, Sports Medicine CurrentSince Nov 1, 2024 Accepting new patients
Spartanburg Medical Center CurrentSince Jan 1, 2004 Accepting new patients
Spartanburg Medical Center CurrentSince Jan 1, 2004 Accepting new patients
Pelham Medical Center Current Accepting new patients

Locations

150 D St
Greer, SC 29651
Phone (864) 560-9646

250 Westmoreland Rd
Greer, SC 29651
Phone (864) 530-2108

101 E Wood St
Ste 300
Spartanburg, SC 29303
Phone (864) 560-6554

853 N Church St
Ste 410A
Spartanburg, SC 29303
Phone (864) 560-6928

1330 Boiling Springs Rd
Ste 1800
Spartanburg, SC 29303
Phone (864) 278-1414

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1138665600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611705600000",
    "number": "1114998671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 743070",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303743070",
            "telephone_number": "864-560-4304",
            "fax_number": "864-560-4413"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1330 BOILING SPRINGS RD",
            "address_2": "SUITE 1800",
            "city": "SPARTANBURG",
            "state": "SC",
            "postal_code": "293034201",
            "telephone_number": "864-560-9646"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOURTADA",
        "first_name": "HUSAM",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-31",
        "last_updated": "2021-01-27",
        "certification_date": "2021-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "204C00000X",
            "taxonomy_group": "",
            "desc": "Neuromusculoskeletal Medicine, Sports Medicine",
            "state": "SC",
            "license": "26527",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "265279",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "067EJ",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDCOST",
            "identifier": "D1678",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7806056",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89067EJ",
            "state": "NC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "hmourtada8489@direct-srhs.et0939.epichosted.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "hmourtada8489@direct-srhs.et0939.epichosted.com",
            "address_1": "1330 Boiling Springs Rd",
            "address_2": "Suite 1800",
            "city": "Spartanburg",
            "state": "SC",
            "country_code": "US",
            "postal_code": "293034201",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Spartanburg, SC

Sources for this page

Verify at the official NPI Registry.