Individual provider Active NPI

Aline Assaker Tomajian, NP

  • Nurse Practitioner
  • Gulfport, MS
National Provider Identifier
1407569379
Registry record updated Mar 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
905712 Issued in MS
Practice address
1340 Broad Ave Ste 450
Gulfport, MS 39501-2460
Phone
(228) 867-5006
NPI assigned
Jan 5, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 8, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 905712 MS Primary

Addresses

Primary practice location

1340 Broad Ave Ste 450
Gulfport, MS 39501-2460

Mailing address

10740 Plantation LN
Gulfport, MS 39503-4058
Phone (832) 594-2921

Other practice location 1

14050 Dedeaux Rd
Gulfport, MS 39503-4502
Phone (228) 702-2000

Other names 1

  • Aline Assaker 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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230329000058 MS Practitioner - Nurse Practitioner 3779957063 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Memorial Hospital at GulfportGroup PAC ID 2466524012, 473 clinicians

Practice addresses (Care Compare)

1340 Broad Ave
Suite 450
Gulfport, MS 39501-2460
Phone (228) 867-5006

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
905712MSMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Memorial Hospital at Gulfport Current Accepting new patients
Memorial Hospital at Gulfport CurrentSince Feb 13, 2023 Accepting new patients

Locations

1340 Broad Ave
Ste 450
Gulfport, MS 39501
Phone (228) 867-5006

1340 Broad Ave
Ste 440
Gulfport, MS 39501
Phone (228) 867-4856

Interoperability endpoints

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

Organizations & group practices 3

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.

Hospital & facility affiliations 60

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

View all 60

NPI Registry JSON

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

{
    "created_epoch": "1672876800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678233600000",
    "number": "1407569379",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10740 PLANTATION LN",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "395034058",
            "telephone_number": "832-594-2921"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1340 BROAD AVE STE 450",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "395012460",
            "telephone_number": "228-867-5006"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "14050 Dedeaux Rd",
            "address_purpose": "LOCATION",
            "city": "Gulfport",
            "state": "MS",
            "postal_code": "395034502",
            "country_code": "US",
            "telephone_number": "228-702-2000",
            "fax_number": "228-702-2018",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TOMAJIAN",
        "first_name": "ALINE",
        "middle_name": "ASSAKER",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-01-05",
        "last_updated": "2023-03-08",
        "certification_date": "2023-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MS",
            "license": "905712",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ALINE",
            "last_name": "ASSAKER",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Gulfport, MS

Sources for this page

Verify at the official NPI Registry.