Bernard G. De Asis, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

17249 Issued in MS

Practice address

117 South 11TH Avenue
Laurel, MS 39440

Phone

(601) 425-3033

Fax

(601) 422-0431

NPI assigned

Jun 27, 2005

Reactivated

Jan 18, 2008

Last updated

Jan 6, 2016By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Family Health Center, Inc

  • Clinic/Center
  • Laurel, MS
  • NPI 1760488357
  Medicare reassignment NPD
• Family Health Center Inc

  • Federally Qualified Health Center (FQHC)
  • Ellisville, MS
  • NPI 1083255087
  NPD
• South Central Regional Medical Center

  • General Acute Care Hospital
  • Laurel, MS
  • NPI 1619973542
  NPD (past)
• Long Island College Hospital

  dba Emergency physicians at LICH

  • Emergency Medicine Physician
  • Brooklyn, NY
  • NPI 1912091828

  Pediatrics

  NPD (past)

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

{
    "created_epoch": "1119830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1452038400000",
    "number": "1275539017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 4361",
            "city": "LAUREL",
            "state": "MS",
            "postal_code": "394414361",
            "telephone_number": "601-425-3033",
            "fax_number": "601-422-0431"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "117 SOUTH 11TH AVENUE",
            "city": "LAUREL",
            "state": "MS",
            "postal_code": "39440",
            "telephone_number": "601-425-3033",
            "fax_number": "601-422-0431"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DE ASIS",
        "first_name": "BERNARD",
        "middle_name": "G.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-27",
        "last_updated": "2016-01-06",
        "deactivation_date": "2007-07-17",
        "reactivation_date": "2008-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "173000000X",
            "taxonomy_group": "",
            "desc": "Legal Medicine",
            "state": "MS",
            "license": "017249",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MS",
            "license": "17249",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00124990",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Edward Watts Davis, OD
• Evan William Davis
• Kerri Guy Davis, D.M.D.
• Haley Dawkins
• Amber J Dawood, DO
• Dearman Medical Group, LLC (Jones Family Medicine Clinics)
• Angela Denise Dearman
• Nick A Deniakos, CRNA
• Cameron Dennis, FNP
• Sophia L Dent, RN

• Pediatrics Physician in Laurel, MS
• Providers in Laurel, MS by specialty
• Pediatrics Physician in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2016; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.