NPIMap

Individual provider Active NPI

Anna Pavlov, MD

  • Plastic and Reconstructive Surgery Physician
  • Gulfport, MS
National Provider Identifier
1821485111
Registry record updated May 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic and Reconstructive Surgery PhysicianTaxonomy code 2086S0122X
License
28641 Issued in MS
Practice address
15190 Community Rd Ste 240
Gulfport, MS 39503-3483
Phone
(228) 202-2128
Fax
(228) 280-0997
NPI assigned
Apr 24, 2015
Last updated
May 9, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 9, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery Physician 208200000X 28641 MS
Plastic and Reconstructive Surgery Physician 2086S0122X 28641 MS Primary

Addresses

Primary practice location

15190 Community Rd Ste 240
Gulfport, MS 39503-3483

Mailing address

2101 Highway 90
Gautier, MS 39553-5340
Phone (228) 497-7576

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
I20210621000063 MS Practitioner - Plastic and Reconstructive Surgery 3577883651 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Plastic and Reconstructive Surgery
Education
University of Mississippi School of Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Singing River Health SystemGroup PAC ID 3870405194, 290 clinicians
Aesthetic Surgery Center LTDGroup PAC ID 9537339387, 2 clinicians

Practice addresses (Care Compare)

3109 Bienville Blvd
Ocean Springs, MS 39564-4361
Phone (228) 818-1111

390 Courthouse Rd
Gulfport, MS 39507-1807
Phone (228) 897-1400

7001 Hwy 614
Coastal Ambulatory Services
Hurley, MS 39555-5340
Phone (228) 588-6622

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Mastectomy17
Melanoma (skin cancer) excision1-10
Removal of tissue16
Removal of skin lesions1-10
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
28641MSMDPlastic and Reconstructive Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Aesthetic Surgery Center LTD Plastic Surgery CurrentSince Mar 1, 2023 Accepting new patients
Memorial Hospital at Gulfport Current Accepting new patients
Memorial Hospital at Gulfport CurrentSince Jul 5, 2021 Accepting new patients
Memorial Hospital at Gulfport CurrentSince Jul 5, 2021 Accepting new patients

Locations

1720A Medical Park Dr
Ste 140
Biloxi, MS 39532
Phone (228) 207-7102

12261 Highway 49
Ste 11
Gulfport, MS 39503
Phone (228) 575-2176

1340 Broad Ave
Ste 440
Gulfport, MS 39501
Phone (228) 867-4856

15190 Community Rd
Ste 240
Gulfport, MS 39503
Phone (228) 539-0489

390 Courthouse Rd
Gulfport, MS 39507
Phone (228) 896-1120

Organizations & group practices 6

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 63

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

View all 63

NPI Registry JSON

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

{
    "created_epoch": "1429833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778284800000",
    "number": "1821485111",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2101 HIGHWAY 90",
            "city": "GAUTIER",
            "state": "MS",
            "postal_code": "395535340",
            "telephone_number": "228-497-7576",
            "fax_number": "228-497-8869"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15190 COMMUNITY RD STE 240",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "395033483",
            "telephone_number": "228-202-2128",
            "fax_number": "228-280-0997"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAVLOV",
        "first_name": "ANNA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-04-24",
        "last_updated": "2026-05-09",
        "certification_date": "2026-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "MS",
            "license": "28641",
            "primary": false
        },
        {
            "code": "2086S0122X",
            "taxonomy_group": "",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "MS",
            "license": "28641",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gulfport, MS

Sources for this page

Verify at the official NPI Registry.