Individual provider Active NPI

Oscar Eduardo Venegas, DDS, MBA

  • Oral and Maxillofacial Surgery (Dentist)
  • Jackson, MS
National Provider Identifier
1730882291
Registry record updated Jun 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
4357-23 Issued in MS
Practice address
2500 North State Street
Jackson, MS 39216
Phone
(601) 984-6001
NPI assigned
Mar 23, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 8, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 4357-23 MS Primary

Addresses

Primary practice location

2500 North State Street
Jackson, MS 39216

Mailing address

2500 North State Street
Jackson, MS 39216

Other names 1

  • Oscar Eduardo Venegas Rebolledo Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231004001174 MS Practitioner - DentistPractitioner - Maxillofacial Surgery 1658725031 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
DentistAlso: Maxillofacial Surgery
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2500 N State St
Jackson, MS 39216-4500
Phone (601) 815-4775

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
83.94 of 100Reported as group
Quality
67.75
Promoting interoperability
100
Improvement activities
40
Cost
71.17

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Business Administration

State licenses

LicenseStateTypeSpecialty
4357-23MSMDOral and Maxillofacial Surgery (Dentist)

Practice roles

OrganizationSpecialtyStatusNew patients
State of Mississippi - University of Mississippi Medical Center CurrentSince May 17, 2023 Accepting new patients
State of Mississippi-University of Mississippi Medical Center CurrentSince May 17, 2023 Accepting new patients
State of Mississippi - University of Mississippi Medical Center Current Accepting new patients

Locations

504 Clinton Center Dr
Ste 4300
Clinton, MS 39056

2500 N State St
Jackson, MS 39216
Phone (601) 815-4775

Interoperability endpoints

  • Direct secure messaging: ovenegas187749@ummc.direct-ci.com

Organizations & group practices 3

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 1

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": "1679529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686182400000",
    "number": "1730882291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 NORTH STATE STREET",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "39216"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 NORTH STATE STREET",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "39216",
            "telephone_number": "601-984-6001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VENEGAS",
        "first_name": "OSCAR",
        "middle_name": "EDUARDO",
        "credential": "DDS, MBA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-03-23",
        "last_updated": "2023-06-08",
        "certification_date": "2023-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "MS",
            "license": "4357-23",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "OSCAR",
            "last_name": "VENEGAS REBOLLEDO",
            "middle_name": "EDUARDO",
            "credential": "DDS, MBA",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Jackson, MS

Sources for this page

Verify at the official NPI Registry.