NPIMap

Individual provider Active NPI

Gregory Patino

  • Emergency Medicine Physician
  • Ocean Springs, MS
National Provider Identifier
1548311103
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
MS17953 Issued in MS
Practice address
3109 Bienville Blvd
Ocean Springs, MS 39564-4361
Phone
(228) 818-1111
NPI assigned
Jan 12, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X MS17953 MS Primary

Addresses

Primary practice location

3109 Bienville Blvd
Ocean Springs, MS 39564-4361

Mailing address

2101 Highway 90
Gautier, MS 39553-5340

Other identifiers 5

IdentifierTypeStateIssuer
00502288MedicaidMS
P00285509OtherMEDICARE RAILROAD
646000515OtherBLUE CROSS OF MS
009934259MedicaidAL
646000515OtherTRICARE

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
I20040311000747 MS Practitioner - Emergency Medicine 3577452242 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
University of Mississippi School of Medicine, 2001
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)

4500 13TH St
Gulfport, MS 39501-2515
Phone (228) 867-5201

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MS17953MSMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Singing River Health System Emergency Medicine CurrentSince Jun 1, 2005 Accepting new patients
Singing River Health System CurrentSince Jun 1, 2005 Accepting new patients
Emergency Room Group LTD Emergency Medicine CurrentSince Feb 15, 2015 Accepting new patients
Memorial Hospital at Gulfport Current Accepting new patients
Singing River Gulfport CurrentSince Nov 19, 2022 Accepting new patients
Singing River Gulfport CurrentSince Nov 19, 2022 Accepting new patients
Memorial Hospital at Gulfport Emergency Medicine CurrentSince Dec 1, 2024 Accepting new patients
St. Dominic Jackson Memorial Emergency Medicine Past Accepting new patients
Singing River Hospital System Past Accepting new patients

Locations

2101 Highway 90
Gautier, MS 39553
Phone (228) 497-7576

350 Cowan Rd
Gulfport, MS 39507
Phone (228) 206-7054

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

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

3109 Bienville Blvd
Ocean Springs, MS 39564
Phone (228) 818-1100

2809 Denny Ave
Pascagoula, MS 39581
Phone (228) 809-5000

Interoperability endpoints

  • Direct secure messaging: gregory.patino.1@18825.direct.athenahealth.com

Organizations & group practices 10

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": "1168560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1548311103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2101 HIGHWAY 90",
            "city": "GAUTIER",
            "state": "MS",
            "postal_code": "395535340"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3109 BIENVILLE BLVD",
            "city": "OCEAN SPRINGS",
            "state": "MS",
            "postal_code": "395644361",
            "telephone_number": "228-818-1111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATINO",
        "first_name": "GREGORY",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MS",
            "license": "MS17953",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00502288",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "P00285509",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS OF MS",
            "identifier": "646000515",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009934259",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "646000515",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ocean Springs, MS

Sources for this page

Verify at the official NPI Registry.