Individual provider Active NPI

Grazyna Wierzbicka, M. D.

  • Pediatrics Physician
  • Pascagoula, MS
National Provider Identifier
1265409478
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
15642 Issued in MS
Practice address
4105 Hospital St
Ste 103
Pascagoula, MS 39581-5312
Phone
(228) 762-8712
Fax
(228) 762-2261
NPI assigned
Mar 7, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 15642 MS Primary

Addresses

Primary practice location

4105 Hospital St
Ste 103
Pascagoula, MS 39581-5312

Mailing address

4105 Hospital St
Ste 103
Pascagoula, MS 39581-5312
Phone (228) 762-8712

Other identifiers 2

IdentifierTypeStateIssuer
0004536051OtherMSAETNA
00118866MedicaidMS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150723007131 AL Practitioner - Pediatric Medicine 5496940801 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
15642MSMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Hospital CurrentSince Jun 1, 2015 Accepting new patients
Providence Hospital CurrentSince Jun 1, 2015 Accepting new patients
Providence Hospital Current Accepting new patients
Childrens Clinic of Pascagoula PLLC Pediatrics Past Accepting new patients

Locations

6801 Airport Blvd
Mobile, AL 36608
Phone (251) 266-3580

Interoperability endpoints

  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1141689600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1265409478",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4105 HOSPITAL ST",
            "address_2": "STE 103",
            "city": "PASCAGOULA",
            "state": "MS",
            "postal_code": "395815312",
            "telephone_number": "228-762-8712",
            "fax_number": "228-762-2261"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4105 HOSPITAL ST",
            "address_2": "STE 103",
            "city": "PASCAGOULA",
            "state": "MS",
            "postal_code": "395815312",
            "telephone_number": "228-762-8712",
            "fax_number": "228-762-2261"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIERZBICKA",
        "first_name": "GRAZYNA",
        "name_prefix": "Dr.",
        "credential": "M. D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-07",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MS",
            "license": "15642",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "0004536051",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00118866",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pascagoula, MS

Sources for this page

Verify at the official NPI Registry.