Dirk H. Danielson, MD
Individual provider Active NPI Emergency Medicine Physician · Picayune, MS
NPI 1104869353 · NPPES record last updated Jul 6, 2010
Key facts
- NPI
- 1104869353
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Emergency Medicine Physician 207P00000X
- License
- 13167 (MS)
- Practice address
- 801Goodyear Blvd.
Picayune, MS 39466-3221 - Phone
- (601) 452-9690
- NPI assigned
- Jun 14, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 11
Hospital & facility affiliations 2
Medicare Care Compare profile
- Specialty
- Emergency Medicine
- 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 LLC
Hattiesburg HB Medical Services LLC
Practice addresses (Care Compare)
1850 Chadwick Dr
Jackson, MS 39204-3404
Phone (601) 376-2832
5001 Hardy St
Hattiesburg, MS 39402-1308
Phone (601) 286-2090
Hospital & facility affiliations
- Merit Health Wesley
- Crossgates River Oaks Hospital
Merit-based Incentive Payment System (MIPS)
- Final score
- 42.86 of 100
- Quality
- 0
- Improvement activities
- 40
- Cost
- 74.29
Merit-based Incentive Payment System (MIPS)
- Final score
- 60.83 of 100
- Quality
- 0
- Improvement activities
- 40
- Cost
- 76.94
Merit-based Incentive Payment System (MIPS)
- Final score
- 73.84 of 100
- Quality
- 26.67
- Improvement activities
- 40
- Cost
- 80.57
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MS
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20040617000409 | MS | Practitioner - Emergency Medicine | 6406830397 | Reassigns benefits to 5 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mississippi Physicians LLP | Emergency Medicine | Current | Accepting new patients |
| Natchez HB Medical Services LLC | Emergency Medicine | Current |
Accepting new patients |
| Mississippi Physicians, LLP | Emergency Medicine | Current |
Accepting new patients |
| App of Mississippi Ed, LLC | Emergency Medicine | Current |
Accepting new patients |
| Jackson HB Medical Services LLC | Emergency Medicine | Current |
Accepting new patients |
| Hattiesburg HB Medical Services LLC | Emergency Medicine | Current |
Accepting new patients |
| Grandiflora Emergency Physicians | Emergency Medicine | Past | Accepting new patients |
| Innovative Health Services LLC | Emergency Medicine | Past |
Accepting new patients |
| Gulfport Emergency Physicians | Emergency Medicine | Past | Accepting new patients |
| Acs Emergency Physicians PA | Emergency Medicine | Past | Accepting new patients |
| Memorial Hospital at Gulfport | Emergency Medicine | Past | Accepting new patients |
Locations
200 Corporate Blvd
Ste 201
Lafayette, LA 70508
150 Reynoir St
Biloxi, MS 39530
Phone (228) 432-7817
161 River Oaks Dr
Canton, MS 39046
Phone (601) 855-4000
5001 Hardy St
Hattiesburg, MS 39402
Phone (601) 268-8000
1225 N State St
Jackson, MS 39202
Phone (601) 292-4261
1850 Chadwick Dr
Jackson, MS 39204
Phone (601) 376-1000
1030 River Oaks Dr
Jackson, MS 39232
Phone (601) 376-2165
54 Sgt Prentiss Dr
Natchez, MS 39120
Phone (601) 443-2100
129 Jefferson Davis Blvd
Natchez, MS 39120
Phone (601) 445-6200
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | 13167 | MS | Yes |
Addresses
Primary practice location
801Goodyear Blvd.
Picayune, MS 39466-3221
Mailing address
200 Corporate Blvd.
Suite 201
Lafayette, LA 70508
Phone (800) 893-9698
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| P00388803 | Other | MS | RAILROAD MCARE THRU IHS |
| P00806413 | Other | MS | RRMCARE THRU HCCN |
| 00125003 | Medicaid | MS |
Other providers in Picayune, MS
- Creekside Pediatric Therapy LLC
- Robert Joseph Crochet III
- Timothy James Cuevas
- Cynthia V Aly- Jean-Pierre
- Joseph J Daho
- Corey C Daspit
- David Futrell
- Bridgett Davis
- DCS Instant Care Clinic Inc.
- Frederick Joseph Deben Jr.
All providers in Picayune, MS · Emergency Medicine Physician in Mississippi
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 6, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.