NPIMap

Individual provider Active NPI

Moustafa A Moustafa, M.D.

  • Nephrology Physician
  • Orangeburg, SC
National Provider Identifier
1356431449
Registry record updated Jun 19, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
17881 Issued in SC
Practice address
3709 Magnolia St
Orangeburg, SC 29118-1403
Phone
(803) 531-2220
Fax
(803) 531-7975
NPI assigned
Oct 13, 2006
Last updated
Jun 19, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X 17881 SC Primary

Addresses

Primary practice location

3709 Magnolia St
Orangeburg, SC 29118-1403

Mailing address

PO Box 2981
Orangeburg, SC 29116-2981
Phone (803) 531-2220

Other identifiers 1

IdentifierTypeStateIssuer
178818MedicaidSC

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
I20100923001045 SC Practitioner - NephrologyPractitioner - Internal Medicine 1254249709 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
NephrologyAlso: Internal Medicine
Education
Other, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
South Carolina Nephrology and HypertensionGroup PAC ID 3274436738, 3 clinicians

Practice addresses (Care Compare)

2046 Main Hwy
Bamberg, SC 29003-1082
Phone (803) 245-5505

3709 Magnolia St
Orangeburg, SC 29118-1403
Phone (803) 531-2220

904 N Jefferies Blvd
Walterboro, SC 29488-2726
Phone (843) 782-4113

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
South Carolina Nephrology and Hypertension Nephrology CurrentSince Jul 8, 2002 Accepting new patients
Musc Community Physicians CurrentSince Nov 1, 2023 Accepting new patients
Musc Community Physicians Current Accepting new patients
Musc Community Physicians CurrentSince Nov 1, 2023 Accepting new patients
Nra-Bamberg, South Carolina, LLC Past Accepting new patients

Locations

2046 Main Hwy
Bamberg, SC 29003
Phone (803) 245-1775

506 North St
Bamberg, SC 29003
Phone (803) 245-6290

3000 Saint Matthews Rd
Orangeburg, SC 29118
Phone (803) 395-2200

3709 Magnolia St
Orangeburg, SC 29118
Phone (803) 531-2220

3709 Magnolia St
Ste B
Orangeburg, SC 29118

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/GAGDDD/Endpoint/GAGDDD
  • Direct secure messaging: mmoustafa442694@direct.musc.edu
  • Direct secure messaging: scnephrologyandhtn.moustafamoustafa@120971.advancedmd-direct.com

Organizations & group practices 6

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 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1160697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1371600000000",
    "number": "1356431449",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2981",
            "city": "ORANGEBURG",
            "state": "SC",
            "postal_code": "291162981",
            "telephone_number": "803-531-2220",
            "fax_number": "803-531-7975"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3709 MAGNOLIA ST",
            "city": "ORANGEBURG",
            "state": "SC",
            "postal_code": "291181403",
            "telephone_number": "803-531-2220",
            "fax_number": "803-531-7975"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOUSTAFA",
        "first_name": "MOUSTAFA",
        "middle_name": "A",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-13",
        "last_updated": "2013-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "SC",
            "license": "17881",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "178818",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Orangeburg, SC

Sources for this page

Verify at the official NPI Registry.