NPIMap

Individual provider Active NPI

Ediz Tasan, M.D.

  • Cardiovascular Disease Physician
  • Pascagoula, MS
National Provider Identifier
1053670166
Registry record updated Jun 24, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
26840 Issued in MS
Practice address
4300 Hospital St Ste 102
Pascagoula, MS 39581
Phone
(228) 762-1002
NPI assigned
May 9, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X R3053 KY
Cardiovascular Disease Physician 207RC0000X 26840 MS Primary

Addresses

Primary practice location

4300 Hospital St Ste 102
Pascagoula, MS 39581

Mailing address

3704 Bienville Blvd Ste B
Ocean Springs, MS 39564-5710
Phone (228) 872-4040

Other practice location 1

800 Rose St Rm Hq-101
Lexington, KY 40536-0293
Phone (305) 484-2236

Other practice location 2

3704 Bienville Blvd Ste B
Ocean Springs, MS 39564-5710
Phone (228) 872-4040

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
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
I20190718000787 MS Practitioner - Cardiovascular Disease (Cardiology) 8224363858 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Gulf Coast Vascular Care, LLCGroup PAC ID 4284053265, 5 clinicians
Singing River Health SystemGroup PAC ID 3870405194, 290 clinicians
Memorial Hospital at GulfportGroup PAC ID 2466524012, 473 clinicians

Practice addresses (Care Compare)

14219 Cook Rd
Biloxi, MS 39532-9719
Phone (228) 207-0810

3109 Bienville Blvd
Ocean Springs, MS 39564-4361
Phone (228) 818-1111

4603 Hospital St
Pascagoula, MS 39581-5337
Phone (228) 822-6040

Hospital & facility affiliations

  • Memorial Hospital at Gulfport Hospital, Gulfport, MS, CCN 250019
  • Singing River Gulfport Hospital, Gulfport, MS, CCN 250123
  • Memorial Hospital Biloxi Hospital, Biloxi, MS, CCN 250007
  • Singing River Health System Hospital, Pascagoula, MS, CCN 250040

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting50
Pacemaker insertion or repair12
Varicose vein removal1-10
Leg revascularization (restoring blood flow)14

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R3053KYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southern Ms Heart Center,PA Cardiovascular Disease CurrentSince Jul 1, 2019 Accepting new patients
Memorial Hospital at Gulfport CurrentSince Aug 1, 2024 Accepting new patients
Memorial Hospital at Gulfport CurrentSince Aug 1, 2024 Accepting new patients
Gulf Coast Vascular Care, LLC CurrentSince Sep 1, 2025 Accepting new patients
Southern Ms Heart Center,PA Cardiovascular Disease CurrentSince Jul 1, 2019 Accepting new patients
Memorial Hospital at Gulfport Current Accepting new patients
Mississippi Cardiovascular Center of Excellence, LLC Cardiovascular Disease CurrentSince Aug 1, 2022 Accepting new patients
Memorial Hospital at Gulfport Past Accepting new patients

Locations

3001 Palm Harbor Blvd
Ste A
Palm Harbor, FL 34683

147 Reynoir St
Ste 307
Biloxi, MS 39530
Phone (228) 435-0100

14219 Cook Rd
Biloxi, MS 39532
Phone (228) 207-0810

147 Reynoir St
Ste 204
Biloxi, MS 39530
Phone (228) 374-6296

2012 Highway 90
Ste 2
Gautier, MS 39553
Phone (228) 300-3007

4500 13th St
#P
Gulfport, MS 39501
Phone (228) 865-3451

1340 Broad Ave
Ste 440
Gulfport, MS 39501
Phone (228) 867-4856

3704 Bienville Blvd
#B
Ocean Springs, MS 39564
Phone (228) 872-4040

3109 Bienville Blvd
Ocean Springs, MS 39564
Phone (228) 818-1100

4603 Hospital St
Pascagoula, MS 39581
Phone (228) 762-1002

2809 Denny Ave
Pascagoula, MS 39581
Phone (228) 809-5000

4300 Hospital St
Ste 102
Pascagoula, MS 39581
Phone (228) 372-8270

Networks

  • LA PPO C-SNP

Organizations & group practices 10

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 63

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

View all 63

NPI Registry JSON

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

{
    "created_epoch": "1336521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1561334400000",
    "number": "1053670166",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3704 BIENVILLE BLVD STE B",
            "city": "OCEAN SPRINGS",
            "state": "MS",
            "postal_code": "395645710",
            "telephone_number": "228-872-4040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4300 HOSPITAL ST STE 102",
            "city": "PASCAGOULA",
            "state": "MS",
            "postal_code": "39581",
            "telephone_number": "228-762-1002"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "800 Rose St Rm Hq-101",
            "address_purpose": "LOCATION",
            "city": "Lexington",
            "state": "KY",
            "postal_code": "405360293",
            "country_code": "US",
            "telephone_number": "305-484-2236",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3704 Bienville Blvd Ste B",
            "address_purpose": "LOCATION",
            "city": "Ocean Springs",
            "state": "MS",
            "postal_code": "395645710",
            "country_code": "US",
            "telephone_number": "228-872-4040",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TASAN",
        "first_name": "EDIZ",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-05-09",
        "last_updated": "2019-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "KY",
            "license": "R3053",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "MS",
            "license": "26840",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pascagoula, MS

Sources for this page

Verify at the official NPI Registry.