NPIMap

Individual provider Active NPI

Nicholas John Fayard, M.D.

  • Surgery Physician
  • Pascagoula, MS
National Provider Identifier
1114126042
Registry record updated Mar 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
22051 Issued in MS
Practice address
2525 Telephone Rd
Pascagoula, MS 39567-3202
Phone
(228) 762-4483
Fax
(228) 762-3147
NPI assigned
Jul 11, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 2, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 22051 MS Primary

Addresses

Primary practice location

2525 Telephone Rd
Pascagoula, MS 39567-3202

Mailing address

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

Other practice location 1

1124 Oakleigh Rd
Ocean Springs, MS 39564-5716
Phone (228) 875-3778

Other practice location 2

15190 Community Rd Ste 260
Gulfport, MS 39503-3471
Phone (228) 875-3778

Other identifiers 1

IdentifierTypeStateIssuer
09129044MedicaidMS

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
I20120730000712 MS Practitioner - General Surgery 6800052275 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Other, 2007
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)

2525 Telephone Rd
Pascagoula, MS 39567-3202
Phone (228) 762-4483

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Hernia repair - groin (open)1-10
Hernia repair (minimally invasive)1-10
Mastectomy1-10
Removal of tissue21
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
22051MSMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Singing River Gulfport CurrentSince Nov 1, 2021 Accepting new patients
Singing River Gulfport CurrentSince Nov 1, 2021 Accepting new patients
Singing River Health System CurrentSince Nov 1, 2021 Accepting new patients
Singing River Gulfport Past Accepting new patients
Singing River Health System Past Accepting new patients

Locations

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

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

1124 Oakleigh Rd
Ocean Springs, MS 39564
Phone (228) 875-3778

2525 Telephone Rd
Pascagoula, MS 39567
Phone (228) 762-4483

Networks

  • LA PPO C-SNP

Organizations & group practices 5

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": "1184112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646179200000",
    "number": "1114126042",
    "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",
            "fax_number": "228-497-8869"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2525 TELEPHONE RD",
            "city": "PASCAGOULA",
            "state": "MS",
            "postal_code": "395673202",
            "telephone_number": "228-762-4483",
            "fax_number": "228-762-3147"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1124 Oakleigh Rd",
            "address_purpose": "LOCATION",
            "city": "Ocean Springs",
            "state": "MS",
            "postal_code": "395645716",
            "country_code": "US",
            "telephone_number": "228-875-3778",
            "fax_number": "228-875-9335",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "15190 Community Rd Ste 260",
            "address_purpose": "LOCATION",
            "city": "Gulfport",
            "state": "MS",
            "postal_code": "395033471",
            "country_code": "US",
            "telephone_number": "228-875-3778",
            "fax_number": "228-875-9335",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FAYARD",
        "first_name": "NICHOLAS",
        "middle_name": "JOHN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-07-11",
        "last_updated": "2022-03-02",
        "certification_date": "2022-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MS",
            "license": "22051",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "09129044",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pascagoula, MS

Sources for this page

Verify at the official NPI Registry.