Individual provider Active NPI

Elizabeth Heroux, PA

  • Physician Assistant
  • Ocean Springs, MS
National Provider Identifier
1063174266
Registry record updated Dec 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA00654 Issued in MS
Practice address
3635 Bienville Blvd Ste B
Ocean Springs, MS 39564-5711
Phone
(228) 872-1951
NPI assigned
Oct 6, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 28, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA00654 MS Primary

Addresses

Primary practice location

3635 Bienville Blvd Ste B
Ocean Springs, MS 39564-5711

Mailing address

2101 Highway 90
Gautier, MS 39553-5340
Phone (228) 497-7576

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220822001725 MS Practitioner - Physician Assistant 5496145344 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Singing River Health SystemGroup PAC ID 3870405194, 290 clinicians

Practice addresses (Care Compare)

3635 Bienville Blvd
Ocean Springs, MS 39564-5711
Phone (228) 872-2403

7001 Hwy 614
Coastal Ambulatory Services
Hurley, MS 39555-5340
Phone (228) 588-6622

967 Cedar Lake Rd
Biloxi, MS 39532-2128
Phone (228) 205-6814

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
4630OKMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Singing River Gulfport CurrentSince Sep 5, 2023 Accepting new patients
Singing River Health System CurrentSince Aug 1, 2022 Accepting new patients
Singing River Health System PastSince Jan 1, 2023 Accepting new patients

Locations

967 Cedar Lake Rd
#A
Biloxi, MS 39532
Phone (228) 205-6830

2101 Highway 90
Gautier, MS 39553
Phone (228) 497-7576

350 Cowan Rd
Gulfport, MS 39507
Phone (228) 206-7054

3635 Bienville Blvd
Ste B
Ocean Springs, MS 39564
Phone (228) 872-1951

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.

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": "1633478400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672185600000",
    "number": "1063174266",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2101 HIGHWAY 90",
            "city": "GAUTIER",
            "state": "MS",
            "postal_code": "395535340",
            "telephone_number": "228-497-7576"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3635 BIENVILLE BLVD STE B",
            "city": "OCEAN SPRINGS",
            "state": "MS",
            "postal_code": "395645711",
            "telephone_number": "228-872-1951"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEROUX",
        "first_name": "ELIZABETH",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-10-06",
        "last_updated": "2022-12-28",
        "certification_date": "2022-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MS",
            "license": "PA00654",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ocean Springs, MS

Sources for this page

Verify at the official NPI Registry.