NPIMap

Individual provider Active NPI

Gabriel Mahasi Buluku

  • Internal Medicine Physician
  • Jackson, MS
National Provider Identifier
1174076749
Registry record updated Jun 6, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
27932 Issued in MS
Practice address
969 Lakeland Dr
Jackson, MS 39216-4606
Phone
(601) 200-4644
Fax
(601) 200-4645
NPI assigned
Jul 29, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 6, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 335312 NC
Internal Medicine Physician 207R00000X 27932 MS Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

969 Lakeland Dr
Jackson, MS 39216-4606

Mailing address

PO Box 22727
Jackson, MS 39225-2727
Phone (601) 200-4644

Other practice location 1

2100 Stantonsburg Rd
Greenville, NC 27834-2818
Phone (252) 847-3898

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
I20200824000665 MS Practitioner - Hospitalist 6709202682 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Hospitalist
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
RH Mississippi Hospitalist Medicine LLCGroup PAC ID 0547791873, 74 clinicians

Practice addresses (Care Compare)

969 Lakeland Dr
Jackson, MS 39216-4606
Phone (601) 200-2000

Hospital & facility affiliations

  • Mississippi Homecare of Jackson Home health agency, Jackson, MS, CCN 257082
  • Sta Home Health Agency of Jackson, Inc. Dba Accentcare Home Health of Jackson Home health agency, Clinton, MS, CCN 257102
  • St Dominic-Jackson Memorial Hospital Hospital, Jackson, MS, CCN 250048
  • Greenwood Leflore Hospital Hospital, Greenwood, MS, CCN 250099
  • Mississippi Baptist Medical Center Hospital, Jackson, MS, CCN 250102

Merit-based Incentive Payment System (MIPS)

Final score
89.09 of 100Reported as apm
Quality
73.43
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
89.09 of 100Reported as apm
Quality
73.43
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
27932MSMDInternal Medicine Physician
335312NCMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southwest Mississippi Regional Medical Center CurrentSince Nov 1, 2022 Accepting new patients
Southwest Mississippi Regional Medical Center Current Accepting new patients
RH Mississippi Hospitalist Medicine, LLC CurrentSince Aug 14, 2024 Accepting new patients
Southwest Mississippi Regional Medical Center CurrentSince Nov 1, 2022 Accepting new patients
St Dominic-Jackson Memorial Hospital Past Accepting new patients
Southwest Mississippi Regional Medical Center Past Accepting new patients

Locations

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

215 Marion Ave
McComb, MS 39648
Phone (601) 249-1180

Organizations & group practices 6

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 5

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": "1469750400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780704000000",
    "number": "1174076749",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 22727",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392252727",
            "telephone_number": "601-200-4644",
            "fax_number": "601-200-4645"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "969 LAKELAND DR",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392164606",
            "telephone_number": "601-200-4644",
            "fax_number": "601-200-4645"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2100 Stantonsburg Rd",
            "address_purpose": "LOCATION",
            "city": "Greenville",
            "state": "NC",
            "postal_code": "278342818",
            "country_code": "US",
            "telephone_number": "252-847-3898",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BULUKU",
        "first_name": "GABRIEL",
        "middle_name": "MAHASI",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-07-29",
        "last_updated": "2026-06-06",
        "certification_date": "2026-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": "335312",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MS",
            "license": "27932",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, MS

Sources for this page

Verify at the official NPI Registry.