NPIMap

Individual provider Active NPI

Ethan Joseph, MD

  • Internal Medicine Physician
  • Charleston, SC
National Provider Identifier
1184281859
Registry record updated May 28, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
LL82566 Issued in SC
Practice address
169 Ashley Avenue
Main Hospital RM 202 Msc333
Charleston, SC 29425
Phone
(843) 792-2300
NPI assigned
May 28, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 28, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X LL82566 SC Primary

Addresses

Primary practice location

169 Ashley Avenue
Main Hospital RM 202 Msc333
Charleston, SC 29425

Mailing address

169 Ashley Avenue
Main Hospital RM 202 Msc333
Charleston, SC 29425

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
I20240226002843 SC Practitioner - OphthalmologyPractitioner - Internal Medicine 2668701335 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
OphthalmologyAlso: Internal Medicine
Education
Medical College of Georgia School of Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
24 On Physicians of SC LLCGroup PAC ID 5890127344, 136 clinicians

Practice addresses (Care Compare)

171 Ashley Ave
Charleston, SC 29425-8908
Phone (843) 792-1414

316 Calhoun St
Charleston, SC 29401-1113
Phone (843) 724-2901

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.09 of 100Reported as group
Quality
79.17
Improvement activities
40
Cost
69.71

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
LL82566SCMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University Medical Associates of the Medical University of South Carol Current Accepting new patients
University Medical Associates of the Medical University of South Carol Internal Medicine CurrentSince May 1, 2025 Accepting new patients
24 On Physicians of SC, LLC CurrentSince Mar 1, 2024 Accepting new patients

Locations

169 Ashley Ave
Rm 202
Charleston, SC 29425
Phone (843) 792-0192

171 Ashley Ave
Charleston, SC 29425
Phone (843) 792-2123

316 Calhoun St
Charleston, SC 29401
Phone (843) 724-2000

2095 Henry Tecklenburg Dr
Charleston, SC 29414
Phone (843) 402-1037

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.

Hospital & facility affiliations 8

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": "1559001600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1559001600000",
    "number": "1184281859",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "169 ASHLEY AVENUE",
            "address_2": "MAIN HOSPITAL RM 202 MSC333",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "29425"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "169 ASHLEY AVENUE",
            "address_2": "MAIN HOSPITAL RM 202 MSC333",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "29425",
            "telephone_number": "843-792-2300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOSEPH",
        "first_name": "ETHAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-05-28",
        "last_updated": "2019-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "SC",
            "license": "LL82566",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, SC

Sources for this page

Verify at the official NPI Registry.