NPIMap

Individual provider Active NPI

Joaquin Andres Hidalgo, M.D.

  • Neurological Surgery Physician
  • Tupelo, MS
National Provider Identifier
1063777472
Registry record updated Jun 14, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
License
26731 Issued in MS
Practice address
4381 S Eason Blvd Ste 302
Tupelo, MS 38801-6584
Phone
(662) 377-5700
NPI assigned
Jul 11, 2012
Last updated
Jun 14, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 14, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery Physician 207T00000X 26731 MS Primary

Addresses

Primary practice location

4381 S Eason Blvd Ste 302
Tupelo, MS 38801-6584

Mailing address

4381 S Eason Blvd Ste 302
Tupelo, MS 38801-6584
Phone (662) 377-5700

Other practice location 1

2500 N State St
Department of Neurosurgery
Jackson, MS 39216-4500
Phone (601) 984-5705

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
I20190621000579 MS Practitioner - Neurosurgery 5698090991 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Neurosurgery
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

415 S 28TH Ave
Hattiesburg Pediatrics Fetal Clinic
Hattiesburg, MS 39401-7246
Phone (888) 815-2005

4381 S Eason Blvd
Suite 302
Tupelo, MS 38801-6584
Phone (662) 377-5700

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Spinal fusion119
Laminectomy or laminotomy (partial removal of spine bones)39

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
26731MSMDNeurological Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
State of Mississippi - University of Mississippi Medical Center Current Accepting new patients
State of Mississippi - University of Mississippi Medical Center CurrentSince Jun 30, 2023 Accepting new patients
North Mississippi Medical Center Current Accepting new patients
North Mississippi Medical Center, Inc. Neurological Surgery CurrentSince Jun 14, 2019 Accepting new patients
North Mississippi Medcial Center, Inc. CurrentSince Jun 14, 2019 Accepting new patients
State of Mississippi-University of Mississippi Medical Center CurrentSince Jun 30, 2023 Accepting new patients
North Mississippi Medical Center Inc Current Accepting new patients
University Physicians, PLLC Past Accepting new patients

Locations

415 S 28th Ave
Hattiesburg, MS 39401
Phone (601) 261-3606

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

4381 S Eason Blvd
Ste 302
Tupelo, MS 38801
Phone (662) 377-5700

830 S Gloster St
Tupelo, MS 38801
Phone (662) 377-3136

Networks

  • LA PPO C-SNP

Interoperability endpoints

  • Direct secure messaging: jhidalgo12215@ummc.direct-ci.com
  • Direct secure messaging: joaquinhidalgo@nmhs.medalliesdirect.net

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1341964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560470400000",
    "number": "1063777472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4381 S EASON BLVD STE 302",
            "city": "TUPELO",
            "state": "MS",
            "postal_code": "388016584",
            "telephone_number": "662-377-5700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4381 S EASON BLVD STE 302",
            "city": "TUPELO",
            "state": "MS",
            "postal_code": "388016584",
            "telephone_number": "662-377-5700"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2500 N State St",
            "address_2": "Department of Neurosurgery",
            "address_purpose": "LOCATION",
            "city": "Jackson",
            "state": "MS",
            "postal_code": "392164500",
            "country_code": "US",
            "telephone_number": "601-984-5705",
            "fax_number": "601-984-6986",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HIDALGO",
        "first_name": "JOAQUIN",
        "middle_name": "ANDRES",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-07-11",
        "last_updated": "2019-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "MS",
            "license": "26731",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tupelo, MS

Sources for this page

Verify at the official NPI Registry.