NPIMap

Individual provider Active NPI

Vistasp Daruwalla, MD

  • Diagnostic Radiology Physician
  • Laurel, MS
National Provider Identifier
1679984546
Registry record updated Apr 23, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
27689 Issued in MS
Practice address
1220 Jefferson St
Laurel, MS 39440-4355
Phone
(814) 534-9104
Fax
(814) 534-3290
NPI assigned
May 14, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MT206379 PA
Diagnostic Radiology Physician 2085R0202X 27689 MS Primary

Addresses

Primary practice location

1220 Jefferson St
Laurel, MS 39440-4355

Mailing address

PO Box 247
Laurel, MS 39441-0247
Phone (601) 428-1000

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
I20200625002344 MS Practitioner - Diagnostic Radiology 9436379971 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Radiology Associates, PAGroup PAC ID 2163404625, 4 clinicians
Magee Benevolent AssociationGroup PAC ID 3678466463, 19 clinicians

Practice addresses (Care Compare)

1220 Jefferson St
Laurel, MS 39440-4355
Phone (601) 428-0100

300 3Rd Ave SE
Magee, MS 39111-3665
Phone (601) 849-5070

300 3Rd Ave SE Northwing
Magee, MS 39111-3665
Phone (601) 849-7702

Hospital & facility affiliations

  • South Central Reg Med Ctr Hospital, Laurel, MS, CCN 250058
  • Magee General Hospital Hospital, Magee, MS, CCN 250124
  • Jasper General Hospital Hospital, Bay Springs, MS, CCN 250018
  • Forrest General Hospital Hospital, Hattiesburg, MS, CCN 250078
  • Wayne General Hospital Hospital, Waynesboro, MS, CCN 250077

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
27689MSMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Magee Benevolent Association CurrentSince Feb 1, 2026 Accepting new patients
Radiology Associates, PA Diagnostic Radiology CurrentSince Jul 1, 2020 Accepting new patients
Magee Benevolent Association CurrentSince Feb 1, 2026 Accepting new patients
South Central Regional Open MRI, LLC CurrentSince Mar 1, 2021 Accepting new patients

Locations

1220 Jefferson St
Laurel, MS 39440
Phone (601) 426-4000

227 S 13th Ave
Laurel, MS 39440
Phone (601) 428-0100

300 SE 3rd Ave
Magee, MS 39111
Phone (601) 849-5070

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 5

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

NPI Registry JSON

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

{
    "created_epoch": "1400025600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776902400000",
    "number": "1679984546",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 247",
            "city": "LAUREL",
            "state": "MS",
            "postal_code": "394410247",
            "telephone_number": "601-428-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1220 JEFFERSON ST",
            "city": "LAUREL",
            "state": "MS",
            "postal_code": "394404355",
            "telephone_number": "814-534-9104",
            "fax_number": "814-534-3290"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DARUWALLA",
        "first_name": "VISTASP",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-05-14",
        "last_updated": "2026-04-23",
        "certification_date": "2026-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MT206379",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MS",
            "license": "27689",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Laurel, MS

Sources for this page

Verify at the official NPI Registry.