NPIMap

Individual provider Active NPI

Mohamed Bassiouny, M.D.

  • Internal Medicine Physician
  • Loris, SC
National Provider Identifier
1962753988
Registry record updated Oct 1, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
TL35103 Issued in SC
Practice address
3655 Mitchell St
Loris, SC 29569-2827
Phone
(843) 716-4300
NPI assigned
Oct 1, 2012
Last updated
Oct 1, 2012By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 1, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X TL35103 SC Primary

Addresses

Primary practice location

3655 Mitchell St
Loris, SC 29569-2827

Mailing address

94 Cedar Ave
North Myrtle Beach, SC 29582

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
I20130129000325 SC Practitioner - Internal Medicine 4789838723 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
McLeod Loris Seacoast HospitalGroup PAC ID 9133394398, 57 clinicians

Practice addresses (Care Compare)

101 McLeod Health Blvd
Suite 201
Myrtle Beach, SC 29579-4477
Phone (843) 646-8001

3655 Mitchell St
Loris, SC 29569-2827
Phone (843) 716-7111

4000 Hwy 9 E
Little River, SC 29566-7833
Phone (843) 390-8100

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
TL35103SCMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
McLeod Loris Seacoast Hospital CurrentSince Jun 1, 2013 Accepting new patients
McLeod Loris Seacoast Hospital CurrentSince Jun 1, 2013 Accepting new patients
McLeod Loris Seacoast Hospital Past Accepting new patients

Locations

3655 Mitchell St
Loris, SC 29569
Phone (843) 716-7000

Interoperability endpoints

  • Direct secure messaging: mbassiouny26092@directmcleodehealth.org

Organizations & group practices 3

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.

Hospital & facility affiliations 8

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": "1349049600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1349049600000",
    "number": "1962753988",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "94 CEDAR AVE",
            "city": "NORTH MYRTLE BEACH",
            "state": "SC",
            "postal_code": "29582"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3655 MITCHELL ST",
            "city": "LORIS",
            "state": "SC",
            "postal_code": "295692827",
            "telephone_number": "843-716-4300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BASSIOUNY",
        "first_name": "MOHAMED",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-10-01",
        "last_updated": "2012-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "SC",
            "license": "TL35103",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Loris, SC

Sources for this page

Verify at the official NPI Registry.