Maria Clarissa Ong Tio, M.D.

Individual provider Active NPI Internal Medicine Physician · Jackson, MS

NPI 1508253188 · NPPES record last updated Jan 18, 2022

Key facts

NPI
1508253188
Entity type
Individual (NPI type 1)
Primary specialty
Internal Medicine Physician 207R00000X
License
28495 (MS)
Practice address
2500 N State St
Jackson, MS 39216-4500
Phone
(601) 815-4775
Fax
(601) 815-4775
NPI assigned
Apr 21, 2015
Sex
Female
Sole proprietor
No

Organizations & group practices 23

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 3

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

Medicare Care Compare profile

Specialty
Nephrology
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
State of Mississippi - University of Mississippi Medical Center (956 clinicians)

Practice addresses (Care Compare)

2500 N State St
Jackson, MS 39216-4500
Phone (601) 898-4404

Hospital & facility affiliations

  • Medical Mall Dialysis Dialysis facility · Jackson, MS · CCN 253503
  • University of Mississippi Med Center Hospital · Jackson, MS · CCN 250001
  • Merit Health Madison Hospital · Canton, MS · CCN 250038

Merit-based Incentive Payment System (MIPS)

Final score
83.94 of 100 (group)
Quality
67.75
Promoting interoperability
100
Improvement activities
40
Cost
71.17

Medicare participation

Medicare fee-for-service enrollment
Enrolled in MS
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20210709002746 MS Practitioner - Nephrology 0042563553 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
28495MSMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
State of Mississippi - University of Mississippi Medical Center Current
since Jul 1, 2021
Accepting new patients
State of Mississippi - University of Mississippi Medical Center Current
since Jul 1, 2021
Accepting new patients

Locations

504 Clinton Center Dr
Ste 4300
Clinton, MS 39056

2500 N State St
Jackson, MS 39216
Phone (601) 815-4775

Interoperability endpoints

  • Direct secure messaging: mtio168597@ummc.direct-ci.com

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 28495 MS Yes

Addresses

Primary practice location

2500 N State St
Jackson, MS 39216-4500

Mailing address

504 Clinton Center Dr Ste 4300
Clinton, MS 39056-5610
Phone (601) 496-9524

Other providers in Jackson, MS

All providers in Jackson, MS · Internal Medicine Physician in Mississippi

Sources for this page

Verify at the official NPI Registry.