NPIMap

Individual provider Active NPI

Hisham Ibrahim Bassiouni, PAC

  • Physician Assistant
  • Myrtle Beach, SC
National Provider Identifier
1205883105
Registry record updated Apr 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA3422 Issued in SC
Practice address
5046 Highway 17 Byp S Ste 103
Myrtle Beach, SC 29588-4503
Phone
(843) 668-4104
NPI assigned
May 27, 2006
Last updated
Apr 8, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2025

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 50001725 OH
Physician Assistant 363A00000X PA3422 SC Primary

Addresses

Primary practice location

5046 Highway 17 Byp S Ste 103
Myrtle Beach, SC 29588-4503

Mailing address

5046 Highway 17 Byp S Ste 103
Myrtle Beach, SC 29588-4503
Phone (843) 668-4104

Other identifiers 1

IdentifierTypeStateIssuer
P00385946OtherRR ERIE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC, NC2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20200330002388 SC Practitioner - Physician Assistant 0244248771 Reassigns benefits to 6 organizations
I20240507002397 NC Practitioner - Physician Assistant 0244248771 Reassigns benefits to 7 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Carolinas Physicians Network IncGroup PAC ID 3375449655, 2,324 clinicians

Practice addresses (Care Compare)

10136 Two Notch Rd
Suite 104
Columbia, SC 29229-4399
Phone (803) 509-7570

14214 Ballantyne Lake Rd
Charlotte, NC 28277-3373

1656 Riverchase Blvd
Suite 1800
Rock Hill, SC 29732-0282
Phone (803) 909-1850

704 Gold Hill Rd
Fort Mill, SC 29715-8906
Phone (803) 835-0420

8720 Dorchester Rd
North Charleston, SC 29420-7303
Phone (843) 552-3629

9332 S Tryon St
Charlotte, NC 28273-3108
Phone (704) 587-6700

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94 of 100Reported as apm
Quality
81.63
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
50001725OHMDPhysician Assistant
PA3422SCMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Carolinas Physicians Network Inc CurrentSince Jul 14, 2025 Accepting new patients
Charleston Carenow Urgent Care, LLC CurrentSince Jun 20, 2026 Accepting new patients
Carolinas Physicians Network Inc CurrentSince Jul 14, 2025 Accepting new patients
Beaufort County Memorial Hospital CurrentSince Mar 29, 2025 Accepting new patients
Medcare Urgent Care Center - Anderson LLC CurrentSince Apr 12, 2023 Accepting new patients
Carolinas Physicians Network Inc CurrentSince Jul 14, 2025 Accepting new patients
Beaufort County Memorial Hospital CurrentSince Mar 29, 2025 Accepting new patients
Carolinas Physicians Network Inc Current Accepting new patients
Georgetown Memorial Hospital CurrentSince Feb 21, 2020 Accepting new patients

Locations

10628 Park Rd
Charlotte, NC 28210
Phone (704) 543-2000

14214 Ballantyne Lake Rd
Ste 100
Charlotte, NC 28277
Phone (704) 667-2650

2001 Vail Ave
Charlotte, NC 28207
Phone (704) 304-5000

955 Ribaut Rd
#C
Beaufort, SC 29902

989 Ribaut Rd
Ste 103
Beaufort, SC 29902
Phone (843) 522-5351

1850 Sam Rittenberg Blvd
Ste B
Charleston, SC 29407
Phone (843) 576-5246

704 Gold Hill Rd
Ste 1200
Fort Mill, SC 29715
Phone (704) 667-3380

606 Black River Rd
Georgetown, SC 29440
Phone (843) 527-7000

8720 Dorchester Rd
North Charleston, SC 29420
Phone (843) 552-3629

110 Medical Cir
Ste A
West Columbia, SC 29169

Interoperability endpoints

  • Direct secure messaging: hbassiouni2810058@carolinashealthcaresystem.direct-ci.com

Organizations & group practices 19

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.

View all 19

Hospital & facility affiliations 6

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": "1148688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744070400000",
    "number": "1205883105",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5046 HIGHWAY 17 BYP S STE 103",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295884503",
            "telephone_number": "843-668-4104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5046 HIGHWAY 17 BYP S STE 103",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295884503",
            "telephone_number": "843-668-4104"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BASSIOUNI",
        "first_name": "HISHAM",
        "middle_name": "IBRAHIM",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-27",
        "last_updated": "2025-04-08",
        "certification_date": "2025-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OH",
            "license": "50001725",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "SC",
            "license": "PA3422",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR ERIE",
            "identifier": "P00385946",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Myrtle Beach, SC

Sources for this page

Verify at the official NPI Registry.