NPIMap

Individual provider Active NPI

Maya Nassim Bougebrayel

  • Physician Assistant
  • Lexington, SC
National Provider Identifier
1144073081
Registry record updated Feb 25, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5392 Issued in SC
Practice address
104 Saluda Pointe Dr
Lexington, SC 29072-7295
Phone
(803) 296-7846
Fax
(803) 296-9699
NPI assigned
Apr 10, 2024
Last updated
Feb 25, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X NU
Physician Assistant 363A00000X 5392 SC Primary

Addresses

Primary practice location

104 Saluda Pointe Dr
Lexington, SC 29072-7295

Mailing address

300 E McBee Ave FL 4
Greenville, SC 29601-2842
Phone (864) 695-6697

Other practice location 1

1015 Munsen Spring Dr
Columbia, SC 29209-1426
Phone (843) 455-1479

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
I20241230001383 SC Practitioner - Physician Assistant 3072040237 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of South Carolina School of Medicine, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Prisma Health Medical Group-MidlandsGroup PAC ID 5991099707, 1,040 clinicians

Practice addresses (Care Compare)

100 Palmetto Health Pkwy
Columbia, SC 29212-1756

101 Business Park Blvd
Columbia, SC 29203-8401
Phone (803) 434-8866

104 Saluda Pointe Dr
Lexington, SC 29072-7295
Phone (803) 296-7846

1120 Roberts Branch Pkwy
Columbia, SC 29203-9144

14 Richland Medical Park Dr
Suite 200
Columbia, SC 29203-6882
Phone (803) 296-7846

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Prisma Health Medical Group-Midlands CurrentSince Dec 9, 2024 Accepting new patients
Prisma Health Medical Group-Midlands CurrentSince Dec 9, 2024 Accepting new patients
Prisma Health Medical Group-Midlands Past Accepting new patients

Locations

1120 Roberts Branch Pkwy
#200
Columbia, SC 29203

14 Richland Medical Park Dr
Ste 200
Columbia, SC 29203
Phone (803) 296-9200

300 E McBee Ave
Fl 4
Greenville, SC 29601
Phone (864) 522-8615

104 Saluda Pointe Dr
Lexington, SC 29072
Phone (803) 296-9200

Interoperability endpoints

  • Direct secure messaging: mbougebrayel459664@direct.ghs.myhfn.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 11

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": "1712707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1771977600000",
    "number": "1144073081",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 E MCBEE AVE FL 4",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296012842",
            "telephone_number": "864-695-6697"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 SALUDA POINTE DR",
            "city": "LEXINGTON",
            "state": "SC",
            "postal_code": "290727295",
            "telephone_number": "803-296-7846",
            "fax_number": "803-296-9699"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1015 Munsen Spring Dr",
            "address_purpose": "LOCATION",
            "city": "Columbia",
            "state": "SC",
            "postal_code": "292091426",
            "country_code": "US",
            "telephone_number": "843-455-1479",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOUGEBRAYEL",
        "first_name": "MAYA",
        "middle_name": "NASSIM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-04-10",
        "last_updated": "2026-02-25",
        "certification_date": "2026-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "SC",
            "license": "5392",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lexington, SC

Sources for this page

Verify at the official NPI Registry.