Dimitrios J Dimitriades, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

16024 Issued in MS

Practice address

394 Courthouse Rd
Suite a
Gulfport, MS 39507-1865

Phone

(228) 896-4417

Fax

(228) 604-0121

NPI assigned

Jun 24, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• Dr. Dimitrios J Dimitriades Professional name

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

Specialty

Family Practice

Education

Louisiana State University School of Medicine in New Orleans, 1994

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Memorial Hospital at GulfportGroup PAC ID 2466524012, 473 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Vitalcaring Group Home health agency, Gulfport, MS, CCN 257090
• Deaconess Homecare- Region I Home health agency, Laurel, MS, CCN 257085
• Saads Home Nursing of Ms Home health agency, Diberville, MS, CCN 257128
• Memorial Hospital at Gulfport Hospital, Gulfport, MS, CCN 250019
• Pearl River County Hospital Hospital, Poplarville, MS, CCN 251333

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ddimitriades@direct.mhg.com

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.

• Memorial Hospital at Gulfport

  • Urology Physician
  • Gulfport, MS
  • NPI 1093142598
  Medicare reassignment Care Compare group
• Memorial Hospital at Gulfport

  • General Acute Care Hospital
  • Biloxi, MS
  • NPI 1215546635
  NPD
• Memorial Hospital at Gulfport

  • Family Medicine Physician
  • Gulfport, MS
  • NPI 1598192080
  NPD
• Memorial Hospital at Gulfport

  • Emergency Medicine Physician
  • Gulfport, MS
  • NPI 1962780379
  NPD
• Memorial Hospital at Gulfport

  • General Acute Care Hospital
  • Gulfport, MS
  • NPI 1073606901
  NPD (past)

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

• Forrest County General Hospital

  • Critical Access Hospital
  • Poplarville, MS
  • NPI 1760789903
  Care Compare affiliation
• Kare-in-Home Health Services, Inc.

  • Home Health Agency
  • Gulfport, MS
  • NPI 1174527030
  Care Compare affiliation
• Memorial Hospital at Gulfport

  • Family Medicine Physician
  • Gulfport, MS
  • NPI 1043542772

  Hospital

  Care Compare affiliation
• Memorial Hospital at Gulfport

  • Internal Medicine Physician
  • Gulfport, MS
  • NPI 1053643791

  Hospital

  Care Compare affiliation
• Memorial Hospital at Gulfport

  • Radiation Oncology Physician
  • Gulfport, MS
  • NPI 1063663490

  Hospital

  Care Compare affiliation
• Memorial Hospital at Gulfport

  • Internal Medicine Physician
  • Gulfport, MS
  • NPI 1063744704

  Hospital

  Care Compare affiliation
• Memorial Hospital at Gulfport

  • General Acute Care Hospital
  • Gulfport, MS
  • NPI 1073606901
  Care Compare affiliation
• Memorial Hospital at Gulfport

  • Urology Physician
  • Gulfport, MS
  • NPI 1093031494

  Hospital

  Care Compare affiliation
• Memorial Hospital at Gulfport

  • Urology Physician
  • Gulfport, MS
  • NPI 1093142598

  Hospital

  Care Compare affiliation
• Memorial Hospital at Gulfport

  • Family Medicine Physician
  • Wiggins, MS
  • NPI 1104477710

  Hospital

  Care Compare affiliation
• Memorial Hospital at Gulfport

  • Gastroenterology Physician
  • Gulfport, MS
  • NPI 1124311055

  Hospital

  Care Compare affiliation
• Memorial Hospital at Gulfport

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Gulfport, MS
  • NPI 1184956815

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1151107200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1404950400000",
    "number": "1851327522",
    "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": "395021810",
            "telephone_number": "228-865-1453",
            "fax_number": "228-868-8504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "394 COURTHOUSE RD",
            "address_2": "SUITE A",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "395071865",
            "telephone_number": "228-896-4417",
            "fax_number": "228-604-0121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIMITRIADES",
        "first_name": "DIMITRIOS",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-24",
        "last_updated": "2014-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MS",
            "license": "16024",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00119666",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "5057532",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "080119197",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DIMITRIOS",
            "last_name": "DIMITRIADES",
            "middle_name": "J",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Dorothy Dickson-Rishel, PHD
• Tiffany McLain Dillard
• Jenesia Arielle Dillow Ordonia
• Leah Ashley Guerrero Dimalanta, OTR/L
• Amy M Dimitriades, NP-C
• Discovering You Supervised Living Homes
• Distinct Home Health Care Inc
• Peggy Ditta, C.R.N.A.
• Brian R Dix, D.O.
• Kiara Dixon

• Family Medicine Physician in Gulfport, MS
• Providers in Gulfport, MS by specialty
• Family Medicine Physician in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2014; 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.

Verify at the official NPI Registry.