NPIMap

Individual provider Active NPI

Bassam Baroudi, M.D.

  • Cardiovascular Disease Physician
  • Gulfport, MS
National Provider Identifier
1487683231
Registry record updated Oct 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
15167 Issued in MS
Practice address
4215 15TH St
Gulfport, MS 39501-2523
Phone
(228) 863-5211
Fax
(228) 863-4101
NPI assigned
Jul 2, 2006
Last updated
Oct 19, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 19, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 15167 MS Primary

Addresses

Primary practice location

4215 15TH St
Gulfport, MS 39501-2523

Mailing address

PO Box 1810
Gulfport, MS 39502-1810
Phone (228) 863-5211

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
I20040902000865 MS Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 9739174236 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)Also: Internal Medicine
Education
Other, 1982
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
Gulfport, MS 39501-2460

1340 Broad Ave
Gulfport, MS 39501-2465

1440 Central Ave E
Wiggins, MS 39577-9602
Phone (601) 928-6700

1756 Popps Ferry Rd
Biloxi, MS 39532-2118

4215 15TH St
Gulfport, MS 39501-2523
Phone (228) 863-5211

4500 13TH St
Gulfport, MS 39501-2515
Phone (228) 867-3152

45000 E Aloha Dr
Suite a
Diamondhead, MS 39525-3373
Phone (228) 822-6006

9424 Three Rivers Rd
Gulfport, MS 39503-4248

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting11
Pacemaker insertion or repair1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
15167MSMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Memorial Hospital at Gulfport Current Accepting new patients
Coast Heart Institute, PLLC Cardiovascular Disease CurrentSince Mar 24, 1999 Accepting new patients
Memorial Hospital at Gulfport Past Accepting new patients

Locations

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

4215 15th St
Gulfport, MS 39501
Phone (228) 863-5211

4300 15th St
#C
Gulfport, MS 39501
Phone (228) 863-5211

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

4500 13th St
#P
Gulfport, MS 39501
Phone (228) 865-3451

Interoperability endpoints

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

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 61

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

View all 61

NPI Registry JSON

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

{
    "created_epoch": "1151798400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697673600000",
    "number": "1487683231",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1810",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "395021810",
            "telephone_number": "228-863-5211",
            "fax_number": "228-575-2917"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4215 15TH ST",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "395012523",
            "telephone_number": "228-863-5211",
            "fax_number": "228-863-4101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAROUDI",
        "first_name": "BASSAM",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-02",
        "last_updated": "2023-10-19",
        "certification_date": "2023-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "MS",
            "license": "15167",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gulfport, MS

Sources for this page

Verify at the official NPI Registry.