Individual provider Active NPI

Lawrence Jeffrey Hubacek, M.D.

  • Emergency Medicine Physician
  • Pearl, MS
National Provider Identifier
1104853936
Registry record updated Jul 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
13184 Issued in MS
Practice address
110A Airport Rd S Ste a
Pearl, MS 39208-6698
Phone
(601) 936-2887
Fax
(855) 866-6287
NPI assigned
Jun 27, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Obesity Medicine (Family Medicine) Physician 207QB0002X 13184 MS
Obesity Medicine (Preventive Medicine) Physician 2083B0002X 13184 MS
Emergency Medicine Physician 207P00000X 13184 MS Primary

Addresses

Primary practice location

110A Airport Rd S Ste a
Pearl, MS 39208-6698

Mailing address

510 Pine Hill PL
Flowood, MS 39232-8994
Phone (769) 798-2921

Other practice location 1

969 Lakeland Dr
Jackson, MS 39216-4606
Phone (601) 200-6175

Other identifiers 2

IdentifierTypeStateIssuer
09014778MedicaidMS
00114632MedicaidMS

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
I20040827000553 MS Practitioner - Emergency MedicinePractitioner - Family Practice 7214902816 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency MedicineAlso: Family Practice
Education
University of Mississippi School of Medicine, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Jackson HB Medical Services LLCGroup PAC ID 6103273131, 50 clinicians

Practice addresses (Care Compare)

1850 Chadwick Dr
Jackson, MS 39204-3404
Phone (601) 376-2832

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
42.86 of 100Reported as group
Quality
0
Improvement activities
40
Cost
74.29

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of nail tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
13184MSMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Relias Emergency Medicine Specialists of St Dominic LLC Emergency Medicine CurrentSince Oct 1, 2021 Accepting new patients
App of Mississippi Ed, LLC Emergency Medicine CurrentSince Dec 29, 2022 Accepting new patients
Jackson HB Medical Services LLC Emergency Medicine CurrentSince Oct 15, 2023 Accepting new patients

Locations

150 Reynoir St
Biloxi, MS 39530
Phone (228) 432-7817

350 Crossgates Blvd
Brandon, MS 39042
Phone (601) 824-8500

1850 Chadwick Dr
Jackson, MS 39204
Phone (601) 376-1000

969 Lakeland Dr
Jackson, MS 39216
Phone (601) 200-4644

Organizations & group practices 3

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 1

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": "1151366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752105600000",
    "number": "1104853936",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "510 PINE HILL PL",
            "city": "FLOWOOD",
            "state": "MS",
            "postal_code": "392328994",
            "telephone_number": "769-798-2921",
            "fax_number": "855-866-6287"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110A AIRPORT RD S STE A",
            "city": "PEARL",
            "state": "MS",
            "postal_code": "392086698",
            "telephone_number": "601-936-2887",
            "fax_number": "855-866-6287"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "969 Lakeland Dr",
            "address_purpose": "LOCATION",
            "city": "Jackson",
            "state": "MS",
            "postal_code": "392164606",
            "country_code": "US",
            "telephone_number": "601-200-6175",
            "fax_number": "601-200-2020",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HUBACEK",
        "first_name": "LAWRENCE",
        "middle_name": "JEFFREY",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-27",
        "last_updated": "2025-07-10",
        "certification_date": "2025-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QB0002X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Obesity Medicine",
            "state": "MS",
            "license": "13184",
            "primary": false
        },
        {
            "code": "2083B0002X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Obesity Medicine",
            "state": "MS",
            "license": "13184",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MS",
            "license": "13184",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "09014778",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00114632",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pearl, MS

Sources for this page

Verify at the official NPI Registry.