NPIMap

Individual provider Active NPI

Daniel Quitman Richardson, MD

  • Plastic Surgery Physician
  • Biloxi, MS
National Provider Identifier
1073670758
Registry record updated Dec 15, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
License
11075 Issued in MS
Practice address
1720A Medical Park Dr
Ste 140
Biloxi, MS 39532-2129
Phone
(228) 392-4454
Fax
(228) 392-4533
NPI assigned
Jan 2, 2007
Last updated
Dec 15, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery Physician 208200000X 11075 MS Primary

Addresses

Primary practice location

1720A Medical Park Dr
Ste 140
Biloxi, MS 39532-2129

Mailing address

PO Box 6066
Gulfport, MS 39506-6066
Phone (228) 392-4454

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
I20110907000762 MS Practitioner - Plastic and Reconstructive Surgery 3870763626 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Plastic and Reconstructive Surgery
Education
University of Mississippi School of Medicine, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aesthetic Surgery Center LTDGroup PAC ID 9537339387, 2 clinicians

Practice addresses (Care Compare)

390 Courthouse Rd
Gulfport, MS 39507-1807
Phone (228) 897-1400

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Mastectomy1-10
Melanoma (skin cancer) excision14
Removal of skin lesions19
Removal or shaving of skin growth1-10
Skin biopsy11

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Aesthetic Surgery Center LTD Plastic Surgery CurrentSince Jul 1, 1991 Accepting new patients

Locations

1720A Medical Park Dr
Ste 140
Biloxi, MS 39532
Phone (228) 207-7102

390 Courthouse Rd
Gulfport, MS 39507
Phone (228) 896-1120

Interoperability endpoints

  • Direct secure messaging: drichardson1@direct.mhg.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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 60

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

View all 60

NPI Registry JSON

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

{
    "created_epoch": "1167696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1481760000000",
    "number": "1073670758",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6066",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "395066066",
            "telephone_number": "228-392-4454",
            "fax_number": "228-392-4533"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1720A MEDICAL PARK DR",
            "address_2": "STE 140",
            "city": "BILOXI",
            "state": "MS",
            "postal_code": "395322129",
            "telephone_number": "228-392-4454",
            "fax_number": "228-392-4533"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICHARDSON",
        "first_name": "DANIEL",
        "middle_name": "QUITMAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-02",
        "last_updated": "2016-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "MS",
            "license": "11075",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Biloxi, MS

Sources for this page

Verify at the official NPI Registry.