Active NPI
Krishna Sai Kommineni, MBBS
- Rheumatology Physician
- Gulfport, MS
National Provider Identifier
1760905236
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Rheumatology Physician
- License
- 29777
- Practice address
- 1110 Broad Ave
Suite 500
Gulfport, MS 39501 - Phone
- (228) 575-2588
- Fax
- (228) 864-4154
- NPI assigned
- Jul 17, 2017
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Rheumatology Physician | 207RR0500X | 29777 | MS | Primary |
Addresses
Primary practice location
1110 Broad Ave
Suite 500
Gulfport, MS 39501
Mailing address
PO Box 1810
Gulfport, MS 39502
Phone (228) 575-1194
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Rheumatology
- Education
- Other, 2015
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1110 Broad Ave
Suite 500
Gulfport, MS 39501-8902
Phone (228) 575-2588
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Memorial Hospital at Gulfport | Rheumatology | Current | Accepting new patients |
| Memorial Hospital at Gulfport | Current | Accepting new patients | |
| Memorial Hospital at Gulfport | Current | Accepting new patients | |
| Memorial Hospital at Gulfport | Past | Accepting new patients |
Locations
1340 Broad Ave
Ste 440
Gulfport, MS 39501
Phone (228) 867-4856
1110 Broad Ave
Ste 500
Gulfport, MS 39501
Phone (228) 575-2588
Interoperability endpoints
- kkommineni@direct.mhg.com
Organizations & group practices 4
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.
-
- General Acute Care Hospital
- Biloxi, MS
- NPI 1215546635
-
- Emergency Medicine Physician
- Gulfport, MS
- NPI 1962780379
-
- General Acute Care Hospital
- Gulfport, MS
- NPI 1073606901
Hospital & facility affiliations 61
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Gulfport, MS
- NPI 1073606901
-
- Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
- Gulfport, MS
- NPI 1184956815
Hospital
-
- General Acute Care Hospital
- Biloxi, MS
- NPI 1215546635
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1500249600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1681084800000",
"number": "1760905236",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1810",
"city": "GULFPORT",
"state": "MS",
"postal_code": "39502",
"telephone_number": "228-575-1194",
"fax_number": "228-575-2917"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1110 BROAD AVE",
"address_2": "SUITE 500",
"city": "GULFPORT",
"state": "MS",
"postal_code": "39501",
"telephone_number": "228-575-2588",
"fax_number": "228-864-4154"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KOMMINENI",
"first_name": "KRISHNA",
"middle_name": "SAI",
"credential": "MBBS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2017-07-17",
"last_updated": "2023-04-10",
"certification_date": "2023-04-10",
"status": "A"
},
"taxonomies": [
{
"code": "207RR0500X",
"taxonomy_group": "",
"desc": "Internal Medicine, Rheumatology",
"state": "MS",
"license": "29777",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Gulfport, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.