Organization Active NPI

Burgaw Medical Center, P.C.

  • Family Medicine Physician
  • Hampstead, NC
National Provider Identifier
1700104775
Registry record updated Feb 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
BURGAW MEDICAL CENTER, P.C.
Practice address
25 N Hampstead Village Dr
Hampstead, NC 28443-3932
Phone
(910) 803-0340
Fax
(910) 803-0342
NPI assigned
May 14, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2025

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

Authorized official

Name
Mostafa Mohamed Rezk, DONPI 1316238173
Title
Owner
Phone
(910) 803-0340

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X

Addresses

Primary practice location

25 N Hampstead Village Dr
Hampstead, NC 28443-3932

Mailing address

25 N Hampstead Village Dr
Hampstead, NC 28443-3932
Phone (910) 803-0340

Other practice location 1

306 S Campbell St
Burgaw, NC 28425-5010
Phone (910) 259-3377

Other identifiers 2

IdentifierTypeStateIssuer
5913552MedicaidNC
5917334MedicaidNC

Other names 1

  • Hampstead Family Medicine Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110518000741 NC Part B Supplier - Clinic/Group Practice 2062698491 Receives reassigned benefits from 2 practitioners
Practice locations: Burgaw, NC; Hampstead, NC

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
34D0245916Burgaw Medical Center306 S Campbell Street, Burgaw, NC 28425Certificate of waiverAug 25, 2027

National Provider Directory

National Provider Directory

Locations

25 N Hampstead Village Dr
Hampstead, NC 28443
Phone (910) 270-6026

144 Merchants Cir
Ste 100
Hampstead, NC 28443
Phone (910) 803-0340

144 Merchants Cir
Hampstead, NC 28443
Phone (910) 803-0340

Practitioners & affiliated clinicians

Practitioners 22

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 22

NPI Registry JSON

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

{
    "created_epoch": "1273795200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1740355200000",
    "number": "1700104775",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 N HAMPSTEAD VILLAGE DR",
            "city": "HAMPSTEAD",
            "state": "NC",
            "postal_code": "284433932",
            "telephone_number": "910-803-0340",
            "fax_number": "910-803-0342"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 N HAMPSTEAD VILLAGE DR",
            "city": "HAMPSTEAD",
            "state": "NC",
            "postal_code": "284433932",
            "telephone_number": "910-803-0340",
            "fax_number": "910-803-0342"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "306 S Campbell St",
            "address_purpose": "LOCATION",
            "city": "Burgaw",
            "state": "NC",
            "postal_code": "284255010",
            "country_code": "US",
            "telephone_number": "910-259-3377",
            "fax_number": "910-259-3013",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "BURGAW MEDICAL CENTER, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-05-14",
        "last_updated": "2025-02-24",
        "certification_date": "2025-02-24",
        "status": "A",
        "authorized_official_last_name": "REZK",
        "authorized_official_first_name": "MOSTAFA",
        "authorized_official_middle_name": "MOHAMED",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "910-803-0340",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5913552",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5917334",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Hampstead Family Medicine",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Hampstead Family Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Hampstead, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.