Individual provider Active NPI

Tricia K Aultman, M.D.

  • Internal Medicine Physician
  • Pascagoula, MS
National Provider Identifier
1346322880
Registry record updated May 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MS17226 Issued in MS
Practice address
2809 Denny Ave
Pascagoula, MS 39581-5301
Phone
(228) 809-5510
Fax
(228) 809-5519
NPI assigned
Oct 20, 2006
Last updated
May 20, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 20, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MS17226 MS Primary

Addresses

Primary practice location

2809 Denny Ave
Pascagoula, MS 39581-5301

Mailing address

2101 Highway 90
Gautier, MS 39553-5340
Phone (228) 497-7576

Other identifiers 1

IdentifierTypeStateIssuer
TA00125439MedicaidMS

Other names 1

  • Dr. Tricia L Kunovich-Frieze Former name

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050614000486 MS Practitioner - Internal MedicinePractitioner - Emergency Medicine 9335183029 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Emory University School of Medicine, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Singing River GulfportGroup PAC ID 5294154829, 75 clinicians
Singing River Health SystemGroup PAC ID 3870405194, 290 clinicians

Practice addresses (Care Compare)

15200 Community Rd
Gulfport, MS 39503-3085
Phone (228) 575-7112

2809 Denny Ave
Pascagoula, MS 39581-5301
Phone (228) 818-0563

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MS17226MSMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Singing River Health System CurrentSince Jun 12, 2023 Accepting new patients
Singing River Health System Internal Medicine CurrentSince Jun 12, 2023 Accepting new patients
Singing River Gulfport CurrentSince Jun 12, 2023 Accepting new patients
Magnolia Medical Center Internal Medicine Past Accepting new patients
Singing River Gulfport Past Accepting new patients
Garden Park Physician Group-Specialty Care, LLC Past Accepting new patients

Locations

15012 Lemoyne Blvd
Biloxi, MS 39532
Phone (228) 392-5050

2101 Highway 90
Gautier, MS 39553
Phone (228) 497-7576

12330 Ashley Dr
Gulfport, MS 39503
Phone (228) 255-8818

15200 Community Rd
Gulfport, MS 39503
Phone (228) 575-7000

350 Cowan Rd
Gulfport, MS 39507
Phone (228) 206-7054

1199 Ocean Springs Rd
Ocean Springs, MS 39564
Phone (228) 875-9363

3109 Bienville Blvd
Ocean Springs, MS 39564
Phone (228) 818-1100

3612 Groveland Rd
Ocean Springs, MS 39564
Phone (228) 818-2530

2809 Denny Ave
Pascagoula, MS 39581
Phone (228) 809-5000

3003 Shortcut Rd
Pascagoula, MS 39567
Phone (228) 273-4096

Interoperability endpoints

  • Direct secure messaging: taultman@direct.mhg.com

Organizations & group practices 6

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 4

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": "1161302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684540800000",
    "number": "1346322880",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2101 HIGHWAY 90",
            "city": "GAUTIER",
            "state": "MS",
            "postal_code": "395535340",
            "telephone_number": "228-497-7576",
            "fax_number": "228-497-8869"
        },
        {
            "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": "228-809-5510",
            "fax_number": "228-809-5519"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AULTMAN",
        "first_name": "TRICIA",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-20",
        "last_updated": "2023-05-20",
        "certification_date": "2023-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MS",
            "license": "MS17226",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "TA00125439",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TRICIA",
            "last_name": "KUNOVICH-FRIEZE",
            "middle_name": "L",
            "prefix": "DR.",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Pascagoula, MS

Sources for this page

Verify at the official NPI Registry.