Individual provider Active NPI

Joseph Leo Maurer, M.D.

  • Pediatrics Physician
  • Greenville, SC
National Provider Identifier
1659543718
Registry record updated Apr 19, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
34449 Issued in SC
Practice address
20 Medical Ridge Dr
Greenville, SC 29605-4267
Phone
(864) 220-7270
Fax
(864) 241-9211
NPI assigned
Mar 29, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 19, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 34449 SC Primary

Addresses

Primary practice location

20 Medical Ridge Dr
Greenville, SC 29605-4267

Mailing address

1 Independence PT
Ste 212
Greenville, SC 29615-4536
Phone (864) 797-6044

Other identifiers 1

IdentifierTypeStateIssuer
APPROVEDMedicaidSC

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
I20120914000030 SC Practitioner - Pediatric Medicine 5294913737 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
34449SCMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Prisma Health University Medical Group CurrentSince Jul 16, 2012 Accepting new patients
Prisma Health University Medical Group Pediatrics Current Accepting new patients

Locations

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

415 Duncan Chapel Rd
Greenville, SC 29617
Phone (864) 271-1450

1 Independence Pt
Ste 212
Greenville, SC 29615
Phone (864) 797-6306

20 Medical Ridge Dr
Greenville, SC 29605
Phone (864) 220-7270

1 Doctors Dr
Greenville, SC 29605
Phone (864) 271-3354

Interoperability endpoints

  • Direct secure messaging: jmaurer7277@direct.ghs.myhfn.org

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1206748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1492560000000",
    "number": "1659543718",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 INDEPENDENCE PT",
            "address_2": "STE 212",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296154536",
            "telephone_number": "864-797-6044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 MEDICAL RIDGE DR",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296054267",
            "telephone_number": "864-220-7270",
            "fax_number": "864-241-9211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAURER",
        "first_name": "JOSEPH",
        "middle_name": "LEO",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-03-29",
        "last_updated": "2017-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "SC",
            "license": "34449",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "APPROVED",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, SC

Sources for this page

Verify at the official NPI Registry.