Active NPI
Roland Joseph Mestayer III, MD
- Diagnostic Radiology Physician
- Pascagoula, MS
National Provider Identifier
1174540066
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diagnostic Radiology Physician
- License
- 12000
- Practice address
- 2809 Denny Ave
Pascagoula, MS 39581-5301 - Phone
- (228) 762-1353
- Fax
- (228) 762-1359
- NPI assigned
- Jul 16, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Diagnostic Radiology Physician | 2085R0202X | 12000 | MS | Primary |
Addresses
Primary practice location
2809 Denny Ave
Pascagoula, MS 39581-5301
Mailing address
1365 Market St
Pascagoula, MS 39567-6604
Phone (228) 762-1353
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| RD55624 | Other | UNITEDHEALTH CARE | |
| 009208060 | Medicaid | AL | |
| 00116263 | Medicaid | MS | |
| 1956465 | Medicaid | LA |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Diagnostic Radiology
- Education
- University of Mississippi School of Medicine, 1985
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
14231 Seaway Rd
Suite 5003
Gulfport, MS 39503-4660
Phone (228) 864-4392
Hospital & facility affiliations
- Singing River Gulfport
- Singing River Health System
- Memorial Hospital at Gulfport
Merit-based Incentive Payment System (MIPS)
- Final score
- 100 of 100
- Quality
- 100
- Improvement activities
- 40
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| SMB Radiology P a | Diagnostic Radiology | Current | Accepting new patients |
| PHC-Cleveland LLC | Diagnostic Radiology | Past | Accepting new patients |
| Lakeland Radiologists P a | Diagnostic Radiology | Past | Accepting new patients |
Locations
4500 13th St
Gulfport, MS 39501
Phone (228) 236-3872
15200 Community Rd
Gulfport, MS 39503
Phone (228) 575-7000
14245 Dedeaux Rd
Gulfport, MS 39503
Phone (228) 314-7226
14231 Seaway Rd
Ste 5003
Gulfport, MS 39503
Phone (228) 864-4392
2809 Denny Ave
Pascagoula, MS 39581
Phone (228) 809-5000
1365 Market St
Pascagoula, MS 39567
Phone (601) 762-1353
Interoperability endpoints
- rmestayer@direct.mhg.com
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.
-
- Diagnostic Radiology Physician
- Pascagoula, MS
- NPI 1609877356
-
- Diagnostic Radiology Physician
- Jackson, MS
- NPI 1861428351
Hospital & facility affiliations 63
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Gulfport, MS
- NPI 1073606901
-
- Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
- Gulfport, MS
- NPI 1184956815
Hospital
-
- General Acute Care Hospital
- Biloxi, MS
- NPI 1215546635
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153008000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1174540066",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1365 MARKET ST",
"city": "PASCAGOULA",
"state": "MS",
"postal_code": "395676604",
"telephone_number": "228-762-1353",
"fax_number": "228-762-1359"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2809 DENNY AVE",
"city": "PASCAGOULA",
"state": "MS",
"postal_code": "395815301",
"telephone_number": "228-762-1353",
"fax_number": "228-762-1359"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MESTAYER",
"first_name": "ROLAND",
"middle_name": "JOSEPH",
"name_prefix": "Dr.",
"name_suffix": "III",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-16",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "MS",
"license": "12000",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITEDHEALTH CARE",
"identifier": "RD55624",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "009208060",
"state": "AL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00116263",
"state": "MS"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1956465",
"state": "LA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Pascagoula, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.