NPIMap

Individual provider Active NPI

Paul G Matherne, MD

  • Family Medicine Physician
  • Gulfport, MS
National Provider Identifier
1730245739
Registry record updated Oct 7, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
09445 Issued in MS
Practice address
1924 E Pass Rd
Gulfport, MS 39507-3715
Phone
(228) 388-4862
Fax
(228) 388-2556
NPI assigned
Dec 28, 2006
Last updated
Oct 7, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2020

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 09445 MS Primary

Addresses

Primary practice location

1924 E Pass Rd
Gulfport, MS 39507-3715

Mailing address

1924 E Pass Rd
Gulfport, MS 39507-3715
Phone (228) 388-4862

Other identifiers 1

IdentifierTypeStateIssuer
000018917MedicaidMS

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
I20101015000013 MS Practitioner - Family Practice 1658404512 Reassigns benefits to 2 organizations
Receives reassigned benefits from 2 practitioners
Practice locations: Gulfport, MS

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Louisiana State University School of Medicine in Shreveport, 1978
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Singing River Health SystemGroup PAC ID 3870405194, 290 clinicians

Practice addresses (Care Compare)

3099 Bienville Blvd
Ocean Springs, MS 39564-4308
Phone (228) 818-0310

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Singing River Health System CurrentSince Jul 14, 2025 Accepting new patients
Ochsner Mississippi, LLC CurrentSince Dec 18, 2020 Accepting new patients
Ochsner Mississippi, LLC Current Accepting new patients
Ochsner Mississippi, LLC CurrentSince Dec 18, 2020 Accepting new patients
Singing River Health System Past Accepting new patients
Paul Matherne, M.D. PastSince Oct 31, 1981 Accepting new patients
Hospital Physician Services - Southeast Professional Corporation Past Accepting new patients

Locations

149 Drinkwater Rd
Bay St Louis, MS 39520
Phone (228) 467-8600

15200 Community Rd
Gulfport, MS 39503
Phone (228) 575-7000

1924 E Pass Rd
Gulfport, MS 39507
Phone (228) 388-4862

3099 Bienville Blvd
Ocean Springs, MS 39564
Phone (228) 872-2403

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

Organizations & group practices 7

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 68

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

View all 68

NPI Registry JSON

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

{
    "created_epoch": "1167264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602028800000",
    "number": "1730245739",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1924 E PASS RD",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "395073715",
            "telephone_number": "228-388-4862",
            "fax_number": "228-388-2556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1924 E PASS RD",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "395073715",
            "telephone_number": "228-388-4862",
            "fax_number": "228-388-2556"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATHERNE",
        "first_name": "PAUL",
        "middle_name": "G",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-28",
        "last_updated": "2020-10-07",
        "certification_date": "2020-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MS",
            "license": "09445",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000018917",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gulfport, MS

Sources for this page

Verify at the official NPI Registry.