Gabriel Zevallos, MD

Key facts

NPI

1013965599

Entity type

Individual (NPI type 1)

Primary specialty

Internal Medicine Physician 207R00000X

License

19002 (MS)

Practice address

215 Marion Ave
McComb, MS 39648-2705

Phone

(601) 249-5500

Fax

(601) 249-1173

NPI assigned

May 5, 2006

Sex

Male

Sole proprietor

No

Organizations & group practices 4

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.

• RH Mississippi Hospitalist Medicine, LLC Hospitalist Physician · Jackson, MS · NPI 1891541207
  Medicare reassignment Care Compare group NPD MS
• St Dominic-Jackson Memorial Hospital General Acute Care Hospital · Jackson, MS · NPI 1306876065
  NPD (past)
• Medical & Surgical Clinic of Irving, P.a. Specialist · Irving, TX · NPI 1376994806
  NPD (past)
• Medical & Surgical Clinic of Irving, P.a. Family Medicine Physician · Irving, TX · NPI 1932273141
  NPD (past) INTERNAL MEDICINE

Hospital & facility affiliations 2

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

• Mississippi Homecare of Jackson II, LLC Home Health Agency · Jackson, MS · NPI 1730373275
  Care Compare affiliation Home health agency
• St Dominic-Jackson Memorial Hospital General Acute Care Hospital · Jackson, MS · NPI 1306876065
  Care Compare affiliation Hospital

Medicare Care Compare profile

Specialty

Internal Medicine

Education

Other, 1996

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

RH Mississippi Hospitalist Medicine LLC (74 clinicians)

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mississippi Homecare of Jackson Home health agency · Jackson, MS · CCN 257082
• St Dominic-Jackson Memorial Hospital Hospital · Jackson, MS · CCN 250048

Merit-based Incentive Payment System (MIPS)

Final score

89.09 of 100 (apm)

Quality

73.43

Promoting interoperability

100

Improvement activities

40

Medicare participation

Medicare fee-for-service enrollment

Enrolled (2 enrollments) in MS, TX

Eligible to order & refer

Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes

Medicare enrollment records

National Provider Directory

Medicare enrollment (NPD)

Yes

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Specialties & licenses

Addresses

Other identifiers

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Mar 2, 2015.

{
    "created_epoch": "1146787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1425254400000",
    "number": "1013965599",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 490",
            "city": "MCCOMB",
            "state": "MS",
            "postal_code": "396490490",
            "telephone_number": "601-249-2701",
            "fax_number": "601-249-2195"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 MARION AVE",
            "city": "MCCOMB",
            "state": "MS",
            "postal_code": "396482705",
            "telephone_number": "601-249-5500",
            "fax_number": "601-249-1173"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZEVALLOS",
        "first_name": "GABRIEL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-05",
        "last_updated": "2015-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MS",
            "license": "19002",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00827374",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in McComb, MS

• Jennifer E Wooten
• Courtney Wyant, DO
• Clarence Yeager
• Daniel Araya Yergaw, MD
• Glenn Zeidman, DO
• Zwound Care

All providers in McComb, MS · Internal Medicine Physician in Mississippi