NPIMap

Individual provider Active NPI

Tony Nguyen Cao

  • Physician Assistant
  • Biloxi, MS
National Provider Identifier
1235520693
Registry record updated Nov 14, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA00293 Issued in MS
Practice address
1720A Medical Park Dr Ste 220
Biloxi, MS 39532
Phone
(228) 230-2663
Fax
(228) 546-3257
NPI assigned
Feb 6, 2015
Sex
Male
Sole proprietor
No

Organizations & group practices 12

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 61

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 61

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bienville Orthopaedic Specialists, LLC 43 clinicians

Practice addresses (Care Compare)

15476 Dedeaux Rd
Suite B
Gulfport, MS 39503-2637
Phone (228) 230-2663

1720 A Medical Park Dr
Suite 220
Biloxi, MS 39532-2127
Phone (228) 392-9355

Hospital & facility affiliations

  • Memorial Hospital at Gulfport Hospital, Gulfport, MS, CCN 250019
  • Singing River Gulfport Hospital, Gulfport, MS, CCN 250123

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
I20160901000516 MS Practitioner - Physician Assistant 3173840329 Reassigns benefits to 4 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
South Central Clinics, Inc. CurrentSince Aug 1, 2016 Accepting new patients
Bienville Orthopaedic Specialists, LLC CurrentSince Dec 2, 2019 Accepting new patients
South Central Clinics, Inc CurrentSince Aug 1, 2016 Accepting new patients
Bienville Orthopaedic Specialists, LLC CurrentSince Dec 2, 2019 Accepting new patients
Cooper Family Medical Center Inc. PastSince Sep 17, 2011 Accepting new patients

Locations

1720A Medical Park Dr
Ste 220
Biloxi, MS 39532
Phone (228) 392-9355

1203 B Ave
Ellisville, MS 39437
Phone (601) 477-8553

15476 Dedeaux Rd
Gulfport, MS 39503
Phone (228) 539-3232

424 S 13th Ave
Laurel, MS 39440
Phone (601) 326-2599

6300 E Lake Blvd
Ste 301
Vancleave, MS 39565

NPPES NPI Registry

Updated by the provider on Nov 14, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA.200790 LA
Physician Assistant 363A00000X PA00293 MS Primary

Addresses

Primary practice location

1720A Medical Park Dr Ste 220
Biloxi, MS 39532

Mailing address

6300 E Lake Blvd Ste 301
Vancleave, MS 39565-6771
Phone (228) 230-2663

Other practice location 1

424 S 13th Ave
Laurel, MS 39440-4345
Phone (601) 649-5990

Other practice location 2

15476 Dedeaux Rd
Gulfport, MS 39503-2637
Phone (228) 230-2663

NPI Registry JSON

The complete record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1423180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1573689600000",
    "number": "1235520693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6300 E LAKE BLVD STE 301",
            "city": "VANCLEAVE",
            "state": "MS",
            "postal_code": "395656771",
            "telephone_number": "228-230-2663"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1720A MEDICAL PARK DR STE 220",
            "city": "BILOXI",
            "state": "MS",
            "postal_code": "39532",
            "telephone_number": "228-230-2663",
            "fax_number": "228-546-3257"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "424 S 13th Ave",
            "address_purpose": "LOCATION",
            "city": "Laurel",
            "state": "MS",
            "postal_code": "394404345",
            "country_code": "US",
            "telephone_number": "601-649-5990",
            "fax_number": "601-425-7510",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "15476 Dedeaux Rd",
            "address_purpose": "LOCATION",
            "city": "Gulfport",
            "state": "MS",
            "postal_code": "395032637",
            "country_code": "US",
            "telephone_number": "228-230-2663",
            "fax_number": "228-546-3257",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CAO",
        "first_name": "TONY",
        "middle_name": "NGUYEN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-02-06",
        "last_updated": "2019-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "LA",
            "license": "PA.200790",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MS",
            "license": "PA00293",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Biloxi, MS

Sources for this page

Verify at the official NPI Registry.