Individual provider Active NPI

Thy Huynh

  • Dermatology Physician
  • Jackson, MS
National Provider Identifier
1043745243
Registry record updated Dec 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
28771 Issued in MS
Practice address
2500 N State St
Jackson, MS 39216-4500
Phone
(601) 815-8000
NPI assigned
Apr 25, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 2, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Dermatology Physician 207N00000X 28771 MS Primary
Pediatric Dermatology Physician 207NP0225X 28771 MS

Addresses

Primary practice location

2500 N State St
Jackson, MS 39216-4500

Mailing address

504 Clinton Center Drive
Cbo - Suite 4300
Clinton, MS 39056
Phone (601) 815-2005

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
I20211202000482 MS Practitioner - Dermatology 3779857040 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
University of Alabama School of Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2500 N State St
Jackson, MS 39216-4500
Phone (601) 984-6441

326 Commerce Ctr Dr
Ridgeland, MS 39157-1216
Phone (601) 815-2005

Merit-based Incentive Payment System (MIPS)

Final score
83.94 of 100Reported as group
Quality
67.75
Promoting interoperability
100
Improvement activities
40
Cost
71.17

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions27
Skin biopsy1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
State of Mississippi - University of Mississippi Medical Center CurrentSince Sep 14, 2021 Accepting new patients
State of Mississippi - University of Mississippi Medical Center CurrentSince Sep 14, 2021 Accepting new patients

Locations

504 Clinton Center Dr
Ste 4300
Clinton, MS 39056

2500 N State St
Jackson, MS 39216
Phone (601) 815-4775

201 Northlake Ave
Ste 211
Ridgeland, MS 39157

Networks

  • LA PPO C-SNP

Interoperability endpoints

  • Direct secure messaging: thuynh78090@ummc.direct-ci.com
  • Direct secure messaging: thy.huynh.1@20428.direct.athenahealth.com

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.

NPI Registry JSON

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

{
    "created_epoch": "1493078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638403200000",
    "number": "1043745243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "504 CLINTON CENTER DRIVE",
            "address_2": "CBO - SUITE 4300",
            "city": "CLINTON",
            "state": "MS",
            "postal_code": "39056",
            "telephone_number": "601-815-2005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 N STATE ST",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392164500",
            "telephone_number": "601-815-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUYNH",
        "first_name": "THY",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-04-25",
        "last_updated": "2021-12-02",
        "certification_date": "2021-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "MS",
            "license": "28771",
            "primary": true
        },
        {
            "code": "207NP0225X",
            "taxonomy_group": "",
            "desc": "Dermatology, Pediatric Dermatology",
            "state": "MS",
            "license": "28771",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, MS

Sources for this page

Verify at the official NPI Registry.