NPIMap

Individual provider Active NPI

William Mitsos, M.D.

  • Obstetrics & Gynecology Physician
  • Greenville, SC
National Provider Identifier
1578533774
Registry record updated Aug 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
88898 Issued in SC
Practice address
1120 Grove Rd
Greenville, SC 29605-4656
Phone
(864) 455-8897
Fax
(864) 455-8555
NPI assigned
Jan 23, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X MD052801L PA
Obstetrics & Gynecology Physician 207V00000X 88898 SC Primary

Addresses

Primary practice location

1120 Grove Rd
Greenville, SC 29605-4656

Mailing address

300 E McBee Ave FL 4
Greenville, SC 29601-2842
Phone (864) 522-8603

Other practice location 1

2315 Myrtle St Ste 290
Erie, PA 16502-4609
Phone (814) 452-5504

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
I20240718001004 SC Practitioner - Obstetrics/Gynecology 1153214531 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1120 Grove Rd
Greenville, SC 29605-4656
Phone (864) 455-8802

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD052801LPAMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Prisma Health University Medical Group Obstetrics & Gynecology CurrentSince Aug 5, 2024 Accepting new patients
Prisma Health University Medical Group CurrentSince Aug 5, 2024 Accepting new patients
Prisma Health-Upstate Past Accepting new patients
Health Futures Inc Past Accepting new patients

Locations

210 Freeman Farm Rd
Duncan, SC 29334
Phone (864) 968-5123

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

1120 Grove Rd
Greenville, SC 29605
Phone (864) 455-8802

Interoperability endpoints

  • Direct secure messaging: wmitsos808413@direct.ghs.myhfn.org

Organizations & group practices 4

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 39

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

View all 39

NPI Registry JSON

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

{
    "created_epoch": "1137974400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722556800000",
    "number": "1578533774",
    "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": "864-522-8603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1120 GROVE RD",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296054656",
            "telephone_number": "864-455-8897",
            "fax_number": "864-455-8555"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2315 Myrtle St Ste 290",
            "address_purpose": "LOCATION",
            "city": "Erie",
            "state": "PA",
            "postal_code": "165024609",
            "country_code": "US",
            "telephone_number": "814-452-5504",
            "fax_number": "814-452-5514",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MITSOS",
        "first_name": "WILLIAM",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-23",
        "last_updated": "2024-08-02",
        "certification_date": "2024-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "PA",
            "license": "MD052801L",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "SC",
            "license": "88898",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, SC

Sources for this page

Verify at the official NPI Registry.