Individual provider Active NPI

Bernadette A Deogaygay, M.D.

  • Nephrology Physician
  • Memphis, TN
National Provider Identifier
1750350757
Registry record updated Aug 12, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
34588 Issued in TN
Practice address
6490 Mount Moriah Road Ext
Suite 200
Memphis, TN 38115-3729
Phone
(901) 565-0244
Fax
(901) 565-0616
NPI assigned
Mar 14, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2010

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X 34588 TN Primary
Nephrology Physician 207RN0300X E3210 AR
Nephrology Physician 207RN0300X 14588 MS

Addresses

Primary practice location

6490 Mount Moriah Road Ext
Suite 200
Memphis, TN 38115-3729

Mailing address

PO Box 752743
Memphis, TN 38175-2743
Phone (901) 565-0244

Other identifiers 10

IdentifierTypeStateIssuer
142433001MedicaidAR
3416199001OtherCIGNA
4030322MedicaidTN
055491MedicaidTN
4030322OtherTNBLUE CROSS BLUE SHIELD
06170061MedicaidMS
114248MedicaidTN
21734MedicaidTN
5M199OtherARBLUE CROSS BLUE SHIELD
3859242MedicaidTN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR, MS, TN3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20100830000459 AR Practitioner - Nephrology 7113001991 Reassigns benefits to 1 organization
I20101105000598 MS Practitioner - Nephrology 7113001991 Reassigns benefits to 1 organization
I20101111000334 TN Practitioner - Nephrology 7113001991 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nephrology
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mid-South Nephrology Consultants PLLCGroup PAC ID 3971585373, 14 clinicians

Practice addresses (Care Compare)

310 S Rhodes St
West Memphis, AR 72301-4215
Phone (901) 565-0244

6490 Mount Moriah Rd Ext
Suite 200
Memphis, TN 38115-3841
Phone (901) 565-0244

7318 Southcrest Pkwy
Southaven, MS 38671-4773
Phone (901) 565-0244

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
85.37 of 100Reported as individual
Quality
55.71
Promoting interoperability
100
Improvement activities
40
Cost
73.11

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
E3210ARMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kidney Specialists, P.C. PastSince Feb 17, 2009 Accepting new patients
Memorial Hospital at Gulfport Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: bdeogaygay33826@direct.acumenmd.com
  • Direct secure messaging: bdeogaygay23260@mlh.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 and National Provider Directory roles.

Hospital & facility affiliations 6

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": "1142294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1281571200000",
    "number": "1750350757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 752743",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381752743",
            "telephone_number": "901-565-0244",
            "fax_number": "901-565-0616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6490 MOUNT MORIAH ROAD EXT",
            "address_2": "SUITE 200",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381153729",
            "telephone_number": "901-565-0244",
            "fax_number": "901-565-0616"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEOGAYGAY",
        "first_name": "BERNADETTE",
        "middle_name": "A",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-14",
        "last_updated": "2010-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "TN",
            "license": "34588",
            "primary": true
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "AR",
            "license": "E3210",
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "MS",
            "license": "14588",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "142433001",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "3416199001",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4030322",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "055491",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "4030322",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "06170061",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "114248",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "21734",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "5M199",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3859242",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Memphis, TN

Sources for this page

Verify at the official NPI Registry.