Individual provider Active NPI

Fortunato Gabriel Padua, MD

  • Orthopaedic Surgery Physician
  • Jackson, MS
National Provider Identifier
1023638517
Registry record updated Jul 31, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
34898 Issued in MS
Practice address
1325 E Fortification St
Jackson, MS 39202-2442
Phone
(601) 354-4488
Fax
(601) 351-5980
NPI assigned
Apr 24, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 34898 MS Primary
Student in an Organized Health Care Education/Training Program 390200000X
Orthopaedic Surgery Physician 207X00000X DR.0078057 CO

Addresses

Primary practice location

1325 E Fortification St
Jackson, MS 39202-2442

Mailing address

1325 E Fortification St
Jackson, MS 39202-2442
Phone (601) 354-4488

Other practice location 1

300 W Ottley Ave
Fruita, CO 81521-2118
Phone (970) 858-2705

Other practice location 2

216 N 21st St # 3F
Philadelphia, PA 19103-1001
Phone (985) 788-3143

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250611000936 MS Practitioner - Orthopedic Surgery 7113349747 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Tulane University School of Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mississippi Sports Medicine and Orthopaedic CenterGroup PAC ID 4981685310, 67 clinicians

Practice addresses (Care Compare)

1325 E Fortification St
Jackson, MS 39202-2442
Phone (601) 354-4488

Hospital & facility affiliations

  • Merit Health River Oaks Hospital, Flowood, MS, CCN 250138
  • St Dominic-Jackson Memorial Hospital Hospital, Jackson, MS, CCN 250048

Procedures performed for Medicare patients

ProcedureNumber of procedures
Lower limb (leg) arthroscopy (minimally invasive joint repair)1-10
Upper limb (arm) arthroscopy (minimally invasive joint repair)83

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mississippi Sports Medicine & Orthopaedic Center Orthopaedic Surgery CurrentSince Jul 24, 2025 Accepting new patients

Locations

1325 E Fortification St
Jackson, MS 39202
Phone (601) 354-4488

Interoperability endpoints

  • Direct secure messaging: fpadua5341413@direct.casso.us.com

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 2

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": "1587686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785456000000",
    "number": "1023638517",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1325 E FORTIFICATION ST",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392022442",
            "telephone_number": "601-354-4488",
            "fax_number": "601-351-5980"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1325 E FORTIFICATION ST",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392022442",
            "telephone_number": "601-354-4488",
            "fax_number": "601-351-5980"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "300 W Ottley Ave",
            "address_purpose": "LOCATION",
            "city": "Fruita",
            "state": "CO",
            "postal_code": "815212118",
            "country_code": "US",
            "telephone_number": "970-858-2705",
            "fax_number": "970-858-9961",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "216 N 21st St # 3F",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191031001",
            "country_code": "US",
            "telephone_number": "985-788-3143",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PADUA",
        "first_name": "FORTUNATO",
        "middle_name": "GABRIEL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-04-24",
        "last_updated": "2026-07-31",
        "certification_date": "2026-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "MS",
            "license": "34898",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "CO",
            "license": "DR.0078057",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, MS

Sources for this page

Verify at the official NPI Registry.