Bart J. Edmiston Sr., MD
Individual provider Active NPI Anesthesiology Physician · Ocean Springs, MS
NPI 1508934464 · NPPES record last updated Dec 28, 2020
Key facts
- NPI
- 1508934464
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Anesthesiology Physician 207L00000X
- License
- 20298 (MS)
- Practice address
- 3631 Bienville Blvd.
Suite a
Ocean Springs, MS 39564 - Phone
- (228) 818-9620
- Fax
- (228) 818-9750
- NPI assigned
- Nov 30, 2006
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 9
Hospital & facility affiliations 61
Medicare Care Compare profile
- Specialty
- Anesthesiology
- Education
- Other, 2003
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Memorial Hospital at Gulfport
Gulf Coast Vascular Care, LLC
Best Anesthesia PLLC
Practice addresses (Care Compare)
1340 Broad Ave
Gulfport, MS 39501-2460
1340 Broad Ave
Gulfport, MS 39501-2465
14209 Cook Rd
Biloxi, MS 39532-9719
Phone (228) 575-2536
14213 Cook Rd
BLDG a
Biloxi, MS 39532-9719
Phone (228) 575-2545
14219 Cook Rd
Biloxi, MS 39532-9719
Phone (228) 207-0810
150 Reynoir St
Biloxi, MS 39530-4130
Phone (228) 284-2389
1756 Popps Ferry Rd
Biloxi, MS 39532-2118
4500 13TH St
Gulfport, MS 39501-2515
Phone (228) 867-3152
57 Ratliff St
Lucedale, MS 39452-5731
Phone (601) 673-6120
Hospital & facility affiliations
- Memorial Hospital at Gulfport
- Memorial Hospital Biloxi
- George Regional Health System
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 ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20081013000266 | MS | Practitioner - Anesthesiology | 1254409626 | Reassigns benefits to 4 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| EC-05-091 | ME | MD | Anesthesiology Physician |
| 20298 | MS | MD | Anesthesiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Evergreen Medical Center LLC | Current | Accepting new patients | |
| Etas, PLLC | Anesthesiology | Current |
Accepting new patients |
| Best Anesthesia, PLLC | Anesthesiology | Current |
Accepting new patients |
| Gulf Coast Vascular Care, LLC | Current |
Accepting new patients | |
| Magnolia State Anesthesia Services, PLLC | Anesthesiology | Current |
Accepting new patients |
| Memorial Hospital at Gulfport | Interventional Pain Medicine | Current | Accepting new patients |
| Memorial Hospital at Gulfport | Interventional Pain Medicine | Current |
Accepting new patients |
| Memorial Hospital at Gulfport | Interventional Pain Medicine | Past | Accepting new patients |
Locations
100 Edwina St
Evergreen, AL 36401
Phone (251) 255-5830
101 Crestview Ave
Evergreen, AL 36401
Phone (251) 578-0184
7956 Vaughn Rd
Ste 165
Montgomery, AL 36116
3001 Palm Harbor Blvd
Ste A
Palm Harbor, FL 34683
150 Reynoir St
Biloxi, MS 39530
Phone (228) 432-7817
1756 Popps Ferry Rd
Ste A
Biloxi, MS 39532
Phone (228) 865-3200
14219 Cook Rd
Biloxi, MS 39532
Phone (228) 207-0810
1340 Broad Ave
Ste 440
Gulfport, MS 39501
Phone (228) 867-4856
4500 13th St
Gulfport, MS 39501
Phone (228) 236-3872
2406 Catalpa Ave
Pascagoula, MS 39567
Phone (228) 202-1006
Interoperability endpoints
- bart.edmiston.p1@direct.southernpain.nextgenshare.com
- bedmiston1@direct.mhg.com
- https://fhir-usa.unify.chbase.com/org/evergre-84838805
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | EC-05-091 | ME | |
| Interventional Pain Medicine Physician | 208VP0014X | 20298 | MS | |
| Anesthesiology Physician | 207L00000X | 20298 | MS | Yes |
Addresses
Primary practice location
3631 Bienville Blvd.
Suite a
Ocean Springs, MS 39564
Mailing address
4500 13TH St
Gulfport, MS 39501-2515
Phone (228) 575-2902
Other providers in Ocean Springs, MS
- E Franklin Rawlings, MD
- Kimmie Medina Earley
- Mary East
- Kimberly Rose Easterling
- Edgewater Eyecare, Inc
- Elizabeth E Edmiston
- Edmonson Family Chiropractic LLC
- Casey Edmonson
- Elizabeth Edmonson
- Edward Robert Cohen
All providers in Ocean Springs, MS · Anesthesiology Physician in Mississippi
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 28, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.