Active NPI
Matthew P Gerald, CRNA
- Certified Registered Nurse Anesthetist
- Hattiesburg, MS
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- R854806
- Practice address
- 415 S 28TH Ave
Hattiesburg, MS 39401-7246 - Phone
- (601) 261-3606
- Fax
- (601) 579-5166
- NPI assigned
- Jul 24, 2006
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Certified Registered Nurse Anesthetist | 367500000X | R854806 | MS | Primary |
Addresses
Primary practice location
415 S 28TH Ave
Hattiesburg, MS 39401-7246
Mailing address
415 S 28TH Ave
Hattiesburg, MS 39401-7246
Phone (601) 261-3606
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00124270 | Medicaid | MS | |
| 1500704 | Medicaid | LA | |
| 640507572NX | Other | MS | AMERICAN ADMIN GROUP |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | mgerald4103@directpatientrecord.com | Health Information Exchange (HIE) |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MS
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Certified Registered Nurse Anesthetist (Crna)
- Education
- Other, 2001
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
100 Methodist Blvd
Hattiesburg, MS 39402-1295
Phone (601) 268-5185
415 S 28TH Ave
Hattiesburg, MS 39401-7246
415 S 28TH Ave 3Rd Floor
Ambulatory Cardiovascular Center of Mississ
Hattiesburg, MS 39401-7246
Phone (601) 268-1734
415 S 28TH Ave FL
Hattiesburg, MS 39401-7246
Phone (601) 264-6000
6051 U S Hwy 49
Forrest General Hospital
Hattiesburg, MS 39401-7200
Phone (601) 264-6000
Hospital & facility affiliations
- Forrest General Hospital
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R854806 | MS | MD | Certified Registered Nurse Anesthetist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Hattiesburg Clinic, PA | Current | Accepting new patients | |
| Gastrointestinal Associates, P.a. | Current | Accepting new patients | |
| Gastrointestinal Associates, P.a. | Current | Accepting new patients | |
| Hattiesburg Clinic PA | Current | Accepting new patients | |
| Gi Alliance Anesthesia of Mississippi PLLC | Nurse Anesthetist, Certified Registered | Current | Accepting new patients |
| Youngs Professional Services LLC | Nurse Anesthetist, Certified Registered | Current | Accepting new patients |
| Gastrointestinal Associates, PA | Nurse Anesthetist, Certified Registered | Current | Accepting new patients |
Locations
2510 Lakeland Dr
Flowood, MS 39232
Phone (601) 355-1234
1000 Turtle Creek Dr
Ste 4
Hattiesburg, MS 39402
Phone (601) 268-5189
415 S 28th Ave
Hattiesburg, MS 39401
Phone (601) 261-3606
1421 N State St
Ste 203
Jackson, MS 39202
Phone (601) 355-1234
1926 23rd Ave
Meridian, MS 39301
Phone (601) 485-1131
3882 Bienville Blvd
Ocean Springs, MS 39564
Phone (228) 872-6290
Organizations & group practices 7
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.
-
- Certified Registered Nurse Anesthetist
- Flowood, MS
- NPI 1780303446
Nurse Anesthetist, Certified Registered
-
- Multi-Specialty Clinic/Center
- Hattiesburg, MS
- NPI 1740213446
-
- Gastroenterology Physician
- Flowood, MS
- NPI 1093765604
-
- Certified Registered Nurse Anesthetist
- New Iberia, LA
- NPI 1922178599
MS, Nurse Anesthetist, Certified Registered
-
- Gastroenterology Physician
- Vicksburg, MS
- NPI 1144412438
-
- Anesthesiology Physician
- Flowood, MS
- NPI 1326587304
Nurse Anesthetist, Certified Registered
-
- Primary Care Clinic/Center
- Flowood, MS
- NPI 1912600354
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Hattiesburg, MS
- NPI 1225041809
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153699200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1597017600000",
"number": "1891717138",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "415 S 28TH AVE",
"city": "HATTIESBURG",
"state": "MS",
"postal_code": "394017246",
"telephone_number": "601-261-3606",
"fax_number": "601-579-5240"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "415 S 28TH AVE",
"city": "HATTIESBURG",
"state": "MS",
"postal_code": "394017246",
"telephone_number": "601-261-3606",
"fax_number": "601-579-5166"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GERALD",
"first_name": "MATTHEW",
"middle_name": "P",
"credential": "CRNA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-24",
"last_updated": "2020-08-10",
"certification_date": "2020-08-10",
"status": "A"
},
"taxonomies": [
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "MS",
"license": "R854806",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00124270",
"state": "MS"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1500704",
"state": "LA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AMERICAN ADMIN GROUP",
"identifier": "640507572NX",
"state": "MS"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "mgerald4103@directpatientrecord.com",
"affiliation": "N",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"address_1": "415 S 28th Ave",
"city": "Hattiesburg",
"state": "MS",
"country_code": "US",
"postal_code": "394017246",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Hattiesburg, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- 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.