NPIMap

Individual provider Active NPI

Cornelius E. Regan Jr., MD

  • Retina Specialist (Ophthalmology) Physician
  • Hattiesburg, MS
National Provider Identifier
1508220252
Registry record updated Dec 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Retina Specialist (Ophthalmology) PhysicianTaxonomy code 207WX0107X
License
27509 Issued in MS
Practice address
109 Millsaps Dr Ste B
Hattiesburg, MS 39402-1587
Phone
(601) 255-0736
NPI assigned
Apr 8, 2016
Last updated
Dec 28, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 28, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 60893 TN
Retina Specialist (Ophthalmology) Physician 207WX0107X 27509 MS Primary

Addresses

Primary practice location

109 Millsaps Dr Ste B
Hattiesburg, MS 39402-1587

Mailing address

109 Millsaps Dr Ste B
Hattiesburg, MS 39402-1587
Phone (601) 255-0736

Other practice location 1

425 Hospital Dr Ste 1
Columbus, MS 39705-1938
Phone (601) 255-0736

Other practice location 2

6694 Poplar Springs Dr
Meridian, MS 39305-1119
Phone (601) 512-0378

Other practice location 3

953 Tommy Munro Dr
Biloxi, MS 39532-2133
Phone (601) 255-0736

Other identifiers 1

IdentifierTypeStateIssuer
000559073MedicaidMS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS, TN2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20200608000788 MS Practitioner - Ophthalmology 5991074569 Reassigns benefits to 1 organization
I20200610001099 TN Practitioner - Ophthalmology 5991074569

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
Louisiana State University School of Medicine in New Orleans, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Retina Specialists of Mississippi, PLLCGroup PAC ID 8820370133, 7 clinicians

Practice addresses (Care Compare)

109 Millsaps Dr
Suite B
Hattiesburg, MS 39402-1587
Phone (601) 255-0736

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

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

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
27509MSMDRetina Specialist (Ophthalmology) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Retina Specialists of Mississippi, PLLC Ophthalmology CurrentSince May 1, 2022 Accepting new patients
Sunil Gupta MD LLC Ophthalmology PastSince May 1, 2022 Accepting new patients

Locations

953 Tommy Munro Dr
Biloxi, MS 39532
Phone (601) 255-0736

425 Hospital Dr
Ste 1
Columbus, MS 39705
Phone (601) 255-0736

109 Millsaps Dr
Ste B
Hattiesburg, MS 39402
Phone (601) 225-0736

Interoperability endpoints

  • Direct secure messaging: cregan@rsm.intellechartdirect.net

Organizations & group practices 2

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 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": "1460073600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672185600000",
    "number": "1508220252",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 MILLSAPS DR STE B",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394021587",
            "telephone_number": "601-255-0736"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 MILLSAPS DR STE B",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394021587",
            "telephone_number": "601-255-0736"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "425 Hospital Dr Ste 1",
            "address_purpose": "LOCATION",
            "city": "Columbus",
            "state": "MS",
            "postal_code": "397051938",
            "country_code": "US",
            "telephone_number": "601-255-0736",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6694 Poplar Springs Dr",
            "address_purpose": "LOCATION",
            "city": "Meridian",
            "state": "MS",
            "postal_code": "393051119",
            "country_code": "US",
            "telephone_number": "601-512-0378",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "953 Tommy Munro Dr",
            "address_purpose": "LOCATION",
            "city": "Biloxi",
            "state": "MS",
            "postal_code": "395322133",
            "country_code": "US",
            "telephone_number": "601-255-0736",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "REGAN",
        "first_name": "CORNELIUS",
        "middle_name": "E.",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-04-08",
        "last_updated": "2022-12-28",
        "certification_date": "2022-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "TN",
            "license": "60893",
            "primary": false
        },
        {
            "code": "207WX0107X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Retina Specialist",
            "state": "MS",
            "license": "27509",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000559073",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hattiesburg, MS

Sources for this page

Verify at the official NPI Registry.