NPIMap

Individual provider Active NPI

Bita Ghaffari, M.D.

  • Family Medicine Physician
  • Diamondhead, MS
National Provider Identifier
1568423697
Registry record updated Dec 19, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
19006 Issued in MS
Practice address
4433 Leisure Time Dr.
Diamondhead, MS 39525-3334
Phone
(228) 586-9229
Fax
(228) 586-9230
NPI assigned
Mar 29, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 19006 MS Primary

Addresses

Primary practice location

4433 Leisure Time Dr.
Diamondhead, MS 39525-3334

Mailing address

149 Drinkwater Blvd.
Bay St. Louis, MS 39520
Phone (228) 467-8676

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
I20070906000273 MS Practitioner - Family PracticePractitioner - Emergency Medicine 5698678803 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Emergency Medicine
Education
Other, 2000
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)

1104 Broad Ave
Gulfport, MS 39501-2414
Phone (228) 822-6811

12261 Hwy 49
Gulfport, MS 39503-2975
Phone (228) 867-5185

1340 Broad Ave
Gulfport, MS 39501-2460

1340 Broad Ave
Gulfport, MS 39501-2465

1756 Popps Ferry Rd
Biloxi, MS 39532-2118

4300 Leisure Time Dr
Diamondhead, MS 39525-3241
Phone (228) 255-4300

4433 Leisure Time Dr
Diamondhead, MS 39525-3259
Phone (228) 575-2848

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

5120 Beatline Rd
Long Beach, MS 39560-3815

Hospital & facility affiliations

  • Enhabit Home Health of the Gulf Coast Home health agency, Gulfport, MS, CCN 257111
  • Mississippi Homecare of Picayune Home health agency, Picayune, MS, CCN 257141
  • Memorial Hospital at Gulfport Hospital, Gulfport, MS, CCN 250019

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Memorial Hospital at Gulfport Current Accepting new patients
Memorial Hospital at Gulfport Family Medicine CurrentSince Feb 6, 2016 Accepting new patients
Alliance Medical Associates Inc Past Accepting new patients
Keith Van Meter & Associates Past Accepting new patients
Memorial Hospital at Gulfport Past Accepting new patients

Locations

4300 Leisure Time Dr
Diamondhead, MS 39525
Phone (228) 255-4300

Interoperability endpoints

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

Organizations & group practices 6

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 62

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

View all 62

NPI Registry JSON

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

{
    "created_epoch": "1143590400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1387411200000",
    "number": "1568423697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "149 DRINKWATER BLVD.",
            "city": "BAY ST. LOUIS",
            "state": "MS",
            "postal_code": "39520",
            "telephone_number": "228-467-8676",
            "fax_number": "228-467-8674"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4433 LEISURE TIME DR.",
            "city": "DIAMONDHEAD",
            "state": "MS",
            "postal_code": "395253334",
            "telephone_number": "228-586-9229",
            "fax_number": "228-586-9230"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GHAFFARI",
        "first_name": "BITA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-29",
        "last_updated": "2013-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MS",
            "license": "19006",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Diamondhead, MS

Sources for this page

Verify at the official NPI Registry.