NPIMap

Individual provider Active NPI

Hristo Shivarov, M.D.

  • Nephrology Physician
  • Ocean Springs, MS
National Provider Identifier
1245639939
Registry record updated Sep 16, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
26939 Issued in MS
Practice address
12 Marks Rd
Ocean Springs, MS 39564
Phone
(228) 872-6329
NPI assigned
Aug 19, 2014
Last updated
Sep 16, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X 26939 MS Primary

Addresses

Primary practice location

12 Marks Rd
Ocean Springs, MS 39564

Mailing address

2712 Criswell Ave
Pascagoula, MS 39567-1143
Phone (228) 762-0713

Other practice location 1

2712 Criswell Ave
Pascagoula, MS 39567-1143
Phone (228) 762-0713

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
I20190830001695 MS Practitioner - NephrologyPractitioner - Internal Medicine 3173852068 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
NephrologyAlso: Internal Medicine
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Nephrology Associates of Mobile, P.a.Group PAC ID 8729061668, 41 clinicians

Practice addresses (Care Compare)

2725 Andrew Ave
Pascagoula, MS 39567-1815
Phone (251) 343-5004

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Ochsner Mississippi, LLC CurrentSince Oct 17, 2021 Accepting new patients
Ochsner Mississippi, LLC CurrentSince Aug 16, 2021 Accepting new patients
Ochsner Mississippi, LLC CurrentSince Aug 16, 2021 Accepting new patients
Ochsner Mississippi, LLC Current Accepting new patients
Nephrology Associates of Mobile, P.a. CurrentSince Jan 1, 2024 Accepting new patients

Locations

149 Drinkwater Rd
Bay St Louis, MS 39520
Phone (228) 467-8600

919 Winter St
Lucedale, MS 39452
Phone (251) 410-8272

12 Marks Rd
Ocean Springs, MS 39564
Phone (228) 872-6329

2712 Criswell Ave
Pascagoula, MS 39567
Phone (228) 696-9690

2725 Andrew Ave
Pascagoula, MS 39567
Phone (228) 284-3880

Interoperability endpoints

  • Direct secure messaging: hshivarov59028@direct.acumenmd.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 6

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": "1408406400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568592000000",
    "number": "1245639939",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2712 CRISWELL AVE",
            "city": "PASCAGOULA",
            "state": "MS",
            "postal_code": "395671143",
            "telephone_number": "228-762-0713"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 MARKS RD",
            "city": "OCEAN SPRINGS",
            "state": "MS",
            "postal_code": "39564",
            "telephone_number": "228-872-6329"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2712 Criswell Ave",
            "address_purpose": "LOCATION",
            "city": "Pascagoula",
            "state": "MS",
            "postal_code": "395671143",
            "country_code": "US",
            "telephone_number": "228-762-0713",
            "fax_number": "228-762-0712",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHIVAROV",
        "first_name": "HRISTO",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-08-19",
        "last_updated": "2019-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "MS",
            "license": "26939",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ocean Springs, MS

Sources for this page

Verify at the official NPI Registry.