Individual provider Active NPI

Michael L Masiowski, MD

  • Emergency Medicine Physician
  • Summerville, SC
National Provider Identifier
1639217821
Registry record updated Apr 24, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
21764 Issued in SC
Practice address
295 Midland Pkwy
Summerville, SC 29485-8104
Phone
(843) 832-5000
NPI assigned
Feb 1, 2007
Last updated
Apr 24, 2009By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 21764 SC Primary

Addresses

Primary practice location

295 Midland Pkwy
Summerville, SC 29485-8104

Mailing address

PO Box 11450
Westminster, CA 92685-1450
Phone (800) 509-8138

Other identifiers 1

IdentifierTypeStateIssuer
T57514MedicaidSC

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080804000000 SC Practitioner - Emergency Medicine 0143394536 Reassigns benefits to 3 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Sound Physicians Emergency Medicine of South Carolina LLC Emergency Medicine CurrentSince Apr 15, 2020 Accepting new patients
Georgetown Memorial Hospital CurrentSince Dec 20, 2016 Accepting new patients
Waccamaw Community Hospital CurrentSince Dec 20, 2016 Accepting new patients
Georgetown Memorial Hospital CurrentSince Dec 20, 2016 Accepting new patients
Mid-Ohio Emergency Services, LLC Emergency Medicine Past Accepting new patients
Emergency Medicine Physicians of Stark County, LTD Emergency Medicine Past Accepting new patients
E Jackson St Emergency Physicians LLC Emergency Medicine Past Accepting new patients

Locations

302 University Pkwy
Aiken, SC 29801
Phone (803) 279-3940

1524 Barnwell Hwy
Denmark, SC 29042
Phone (803) 395-3352

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

4070 Highway 17
Murrells Inlt, SC 29576
Phone (843) 357-5100

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

Interoperability endpoints

  • Direct secure messaging: mmasiowski447614@direct.musc.edu

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1170288000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1240531200000",
    "number": "1639217821",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 11450",
            "city": "WESTMINSTER",
            "state": "CA",
            "postal_code": "926851450",
            "telephone_number": "800-509-8138"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "295 MIDLAND PKWY",
            "city": "SUMMERVILLE",
            "state": "SC",
            "postal_code": "294858104",
            "telephone_number": "843-832-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MASIOWSKI",
        "first_name": "MICHAEL",
        "middle_name": "L",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-01",
        "last_updated": "2009-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "SC",
            "license": "21764",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "T57514",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Summerville, SC

Sources for this page

Verify at the official NPI Registry.