NPIMap

Individual provider Active NPI

Daniel Adams, MD

  • Diagnostic Radiology Physician
  • Gulfport, MS
National Provider Identifier
1396165387
Registry record updated Jul 24, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
26825 Issued in MS
Practice address
4500 13TH St
Gulfport, MS 39501-2515
Phone
(228) 867-4000
Fax
(228) 868-7103
NPI assigned
Apr 17, 2014
Last updated
Jul 24, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Diagnostic Radiology Physician 2085R0202X 26825 MS Primary

Addresses

Primary practice location

4500 13TH St
Gulfport, MS 39501-2515

Mailing address

PO Box 1330
Gulfport, MS 39502-1330
Phone (877) 406-2916

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
I20190814003029 MS Practitioner - Diagnostic Radiology 6103120696 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Louisiana State University School of Medicine in Shreveport, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
SMB Radiology P aGroup PAC ID 9234136060, 22 clinicians

Practice addresses (Care Compare)

14231 Seaway Rd
Suite 5003
Gulfport, MS 39503-4660
Phone (228) 864-4392

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
26825MSMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
SMB Radiology P a Diagnostic Radiology CurrentSince Jul 1, 2019 Accepting new patients

Locations

14231 Seaway Rd
Ste 5003
Gulfport, MS 39503
Phone (228) 864-4392

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

4500 13th St
Gulfport, MS 39501
Phone (228) 236-3872

1365 Market St
Pascagoula, MS 39567
Phone (601) 762-1353

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

Organizations & group practices 1

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 64

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

View all 64

NPI Registry JSON

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

{
    "created_epoch": "1397692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563926400000",
    "number": "1396165387",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1330",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "395021330",
            "telephone_number": "877-406-2916",
            "fax_number": "228-868-7103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4500 13TH ST",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "395012515",
            "telephone_number": "228-867-4000",
            "fax_number": "228-868-7103"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ADAMS",
        "first_name": "DANIEL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-04-17",
        "last_updated": "2019-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MS",
            "license": "26825",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gulfport, MS

Sources for this page

Verify at the official NPI Registry.