Michael Jay Loebenberg, M.D.

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

License

17240 Issued in MS

Practice address

3890 Bienville Blvd
Ocean Springs, MS 39564-5803

Phone

(228) 872-6291

Fax

(228) 872-7627

NPI assigned

Jul 27, 2005

Sex

Male

Sole proprietor

No

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

Interoperability endpoints

• Direct secure messaging: michaelloebenberg@dhc.allscriptsdirect.net

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jan 27, 2014.

{
    "created_epoch": "1122422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1390780800000",
    "number": "1790785277",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3890 BIENVILLE BLVD",
            "city": "OCEAN SPRINGS",
            "state": "MS",
            "postal_code": "395645803",
            "telephone_number": "228-872-6291",
            "fax_number": "228-872-7627"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3890 BIENVILLE BLVD",
            "city": "OCEAN SPRINGS",
            "state": "MS",
            "postal_code": "395645803",
            "telephone_number": "228-872-6291",
            "fax_number": "228-872-7627"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOEBENBERG",
        "first_name": "MICHAEL",
        "middle_name": "JAY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-27",
        "last_updated": "2014-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "MS",
            "license": "17240",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00124460",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• All providers in Ocean Springs, MS
• Gastroenterology Physician in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.