NPIMap

Individual provider Active NPI

Muhammad Y Ebrahim, MD

  • Nephrology Physician
  • Spartanburg, SC
National Provider Identifier
1689654071
Registry record updated Nov 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
SC20986 Issued in SC
Practice address
322 N Pine St
Spartanburg, SC 29302-1631
Phone
(864) 582-5099
Fax
(864) 327-1098
NPI assigned
Jan 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2021

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 SC20986 SC Primary

Addresses

Primary practice location

322 N Pine St
Spartanburg, SC 29302-1631

Mailing address

322 N Pine St
Spartanburg, SC 29302-1631
Phone (864) 582-5099

Other identifiers 5

IdentifierTypeStateIssuer
20053698OtherSCSELECT HEALTH
P00319329OtherSCRAIL ROAD MEDICARE
6906287MedicaidNC
H086708516OtherSCMEDICARE
209866MedicaidSC

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
I20040519000071 SC Practitioner - Nephrology 9830189356 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nephrology
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Nephrology Associates of Spartanburg LLCGroup PAC ID 4284647900, 8 clinicians

Practice addresses (Care Compare)

322 N Pine St
Spartanburg, SC 29302-1631
Phone (864) 582-5099

Hospital & facility affiliations

  • Dci West Spartanburg Dialysis facility, Spartanburg, SC, CCN 422560
  • Dci East Spartanburg Dialysis facility, Spartanburg, SC, CCN 422522
  • Dci Gaffney Dialysis facility, Gaffney, SC, CCN 422553
  • Dci Union Dialysis facility, Union, SC, CCN 422552
  • DCI Woodruff Dialysis facility, Woodruff, SC, CCN 422664
  • Spartanburg Medical Center Hospital, Spartanburg, SC, CCN 420007
  • Pelham Medical Center Hospital, Greer, SC, CCN 420103
  • Union Medical Center Hospital, Union, SC, CCN 420108
  • Cherokee Medical Center Hospital, Gaffney, SC, CCN 420043

Merit-based Incentive Payment System (MIPS)

Final score
80.1 of 100Reported as individual
Quality
50.2
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
SC20986SCMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Nephrology Associates of Spartanburg, LLC Nephrology CurrentSince Jul 1, 2006 Accepting new patients

Locations

128 Dillon Dr
Spartanburg, SC 29307
Phone (864) 582-5099

322 N Pine St
Spartanburg, SC 29302
Phone (864) 582-5099

Organizations & group practices 1

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 10

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": "1137715200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636934400000",
    "number": "1689654071",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "322 N PINE ST",
            "city": "SPARTANBURG",
            "state": "SC",
            "postal_code": "293021631",
            "telephone_number": "864-582-5099",
            "fax_number": "864-327-1098"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "322 N PINE ST",
            "city": "SPARTANBURG",
            "state": "SC",
            "postal_code": "293021631",
            "telephone_number": "864-582-5099",
            "fax_number": "864-327-1098"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EBRAHIM",
        "first_name": "MUHAMMAD",
        "middle_name": "Y",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-20",
        "last_updated": "2021-11-15",
        "certification_date": "2021-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "SC",
            "license": "SC20986",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SELECT HEALTH",
            "identifier": "20053698",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAIL ROAD MEDICARE",
            "identifier": "P00319329",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6906287",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "H086708516",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "209866",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Spartanburg, SC

Sources for this page

Verify at the official NPI Registry.