Mary Beth Gadarowski, MD
Individual provider Active NPI Dermatology Physician · Keesler Afb, MS
NPI 1619501293 · NPPES record last updated Jul 19, 2025
Key facts
- NPI
- 1619501293
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dermatology Physician 207N00000X
- License
- 0101273030 (VA)
- Practice address
- 301 Fisher St
Keesler Afb, MS 39534-2508 - Phone
- (228) 376-3501
- NPI assigned
- Feb 23, 2020
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Dermatology
- Education
- State University of Ny Upstate Medical University, 2020
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- The Dermatology Clinic, PLLC
Practice addresses (Care Compare)
11295 E Taylor Rd
Gulfport, MS 39503-4197
Phone (228) 864-3300
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 |
|---|---|---|---|---|
| I20260306002507 | MS | Practitioner - Dermatology | 1850796335 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Dermatology Clinic, PLLC | Dermatology | Current |
Accepting new patients |
Locations
11295 E Taylor Rd
Gulfport, MS 39503
Phone (228) 864-3300
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Physician | 208D00000X | 0101273030 | VA | |
| Military Health Care Provider | 171000000X | |||
| Dermatology Physician | 207N00000X | 0101273030 | VA | Yes |
Addresses
Primary practice location
301 Fisher St
Keesler Afb, MS 39534-2508
Mailing address
301 Fisher St
Keesler Afb, MS 39534-2508
Phone (228) 376-3501
Other providers in Keesler Afb, MS
- Anthony Esparza
- Fernando H Ferrera
- Jennifer Mary Field
- Jeffrey Allen Ford
- Cassie Foss
- Britain Gailliot
- Ian Gaspar
- Suzana M Gjekaj
- Lena Elizabeth Gowring
- Megan Green
All providers in Keesler Afb, MS · Dermatology 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 Jul 19, 2025. 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.