Individual provider Active NPI

John Andrew Mouzakis, M.D.

  • Dermatology Physician
  • Columbia, SC
National Provider Identifier
1124314570
Registry record updated May 29, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
37979 Issued in SC
Practice address
3600 Forest Dr Ste 400
Columbia, SC 29204-4057
Phone
(803) 779-7316
Fax
(803) 343-2538
NPI assigned
Jun 23, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 29, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 37979 SC Primary

Addresses

Primary practice location

3600 Forest Dr Ste 400
Columbia, SC 29204-4057

Mailing address

3600 Forest Dr Ste 400
Columbia, SC 29204-4057
Phone (803) 779-7316

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150904002115 SC Practitioner - Dermatology 2769798727 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
University of South Florida College of Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
CSC Acquisition, LLCGroup PAC ID 2860389160, 16 clinicians

Practice addresses (Care Compare)

3600 Forest Dr
Suite 400
Columbia, SC 29204-4057
Phone 8037797316205

7039 Saint Andrews Rd
Columbia, SC 29212-1177
Phone 8037797316205

Merit-based Incentive Payment System (MIPS)

Final score
87.55 of 100Reported as group
Quality
90
Promoting interoperability
92
Improvement activities
40
Cost
75.16

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision142
Removal of tissue1-10
Removal of skin lesions3045
Removal or shaving of skin growth41
Skin biopsy722

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
37979SCMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
CSC Acquisition, LLC Dermatology CurrentSince Aug 26, 2015 Accepting new patients
CSC Acquisition, LLC Dermatology Current Accepting new patients
CSC Acquisition, LLC Dermatology CurrentSince Aug 26, 2015 Accepting new patients

Locations

1205 Lyttleton St
Camden, SC 29020
Phone (803) 432-5783

3600 Forest Dr
Ste 400
Columbia, SC 29204
Phone (803) 779-7316

7039 Saint Andrews Rd
Columbia, SC 29212
Phone (803) 749-0097

448 Old Cherokee Rd
Lexington, SC 29072
Phone (803) 520-5800

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1308787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1559088000000",
    "number": "1124314570",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3600 FOREST DR STE 400",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292044057",
            "telephone_number": "803-779-7316",
            "fax_number": "803-343-2538"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3600 FOREST DR STE 400",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292044057",
            "telephone_number": "803-779-7316",
            "fax_number": "803-343-2538"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOUZAKIS",
        "first_name": "JOHN",
        "middle_name": "ANDREW",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-06-23",
        "last_updated": "2019-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "SC",
            "license": "37979",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, SC

Sources for this page

Verify at the official NPI Registry.