NPIMap

Individual provider Active NPI

Mitchell Joseph Isaac, MD

  • Otolaryngology Physician
  • Conway, SC
National Provider Identifier
1790213973
Registry record updated Aug 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
41136 Issued in SC
Practice address
620 Singleton Ridge Rd
Conway, SC 29526-9154
Phone
(843) 347-7300
Fax
(843) 347-8459
NPI assigned
Jun 1, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X LL41136 SC
Otolaryngology Physician 207Y00000X 41136 SC Primary

Addresses

Primary practice location

620 Singleton Ridge Rd
Conway, SC 29526-9154

Mailing address

300 Singleton Ridge Rd
Attn PNS Credentialing
Conway, SC 29526-9142
Phone (843) 234-6946

Other practice location 1

6010 Highway 707 Ste 300
Myrtle Beach, SC 29588-7321
Phone (843) 347-7300

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
I20220817000359 SC Practitioner - Otolaryngology 9335415298 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
Medical University of South Carolina College of Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Conway Hospital IncGroup PAC ID 7113839606, 127 clinicians

Practice addresses (Care Compare)

620 Singleton Ridge Rd
Conway, SC 29526-9154
Phone (843) 347-7300

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
52.78 of 100Reported as group
Quality
55.48
Improvement activities
0
Cost
74.21

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
41136SCMDOtolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Conway Hospital, Inc. CurrentSince Aug 4, 2022 Accepting new patients
Conway Hospital, Inc. Past Accepting new patients

Locations

394 Singleton Ridge Rd
Conway, SC 29526
Phone (843) 347-8050

620 Singleton Ridge Rd
Conway, SC 29526
Phone (843) 347-7300

300 Singleton Ridge Rd
Conway, SC 29526
Phone (843) 234-6946

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.

Hospital & facility affiliations 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1496275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659312000000",
    "number": "1790213973",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 SINGLETON RIDGE RD",
            "address_2": "ATTN PNS CREDENTIALING",
            "city": "CONWAY",
            "state": "SC",
            "postal_code": "295269142",
            "telephone_number": "843-234-6946"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 SINGLETON RIDGE RD",
            "city": "CONWAY",
            "state": "SC",
            "postal_code": "295269154",
            "telephone_number": "843-347-7300",
            "fax_number": "843-347-8459"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6010 Highway 707 Ste 300",
            "address_purpose": "LOCATION",
            "city": "Myrtle Beach",
            "state": "SC",
            "postal_code": "295887321",
            "country_code": "US",
            "telephone_number": "843-347-7300",
            "fax_number": "843-347-8459",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ISAAC",
        "first_name": "MITCHELL",
        "middle_name": "JOSEPH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-06-01",
        "last_updated": "2022-08-01",
        "certification_date": "2022-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "SC",
            "license": "LL41136",
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "SC",
            "license": "41136",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Conway, SC

Sources for this page

Verify at the official NPI Registry.