Edward I Dvorak, MD
Individual provider Active NPI Surgery Physician · Pascagoula, MS
NPI 1902820525 · NPPES record last updated May 2, 2022
Key facts
- NPI
- 1902820525
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Surgery Physician 208600000X
- License
- 15891 (MS)
- Practice address
- 2525 Telephone Rd
Pascagoula, MS 39567 - Phone
- (228) 762-4483
- Fax
- (228) 769-0406
- NPI assigned
- Jul 27, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 14
Hospital & facility affiliations 4
Medicare Care Compare profile
- Specialty
- General Surgery
- Education
- University of Tennessee, HSC, College of Medicine, 1993
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Singing River Health System
Practice addresses (Care Compare)
2525 Telephone Rd
Pascagoula, MS 39567-3202
Phone (228) 762-4483
Hospital & facility affiliations
- Deaconess Homecare- Region I
- Singing River Gulfport
- Singing River Health System
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Colonoscopy | 1-10 |
| Hernia repair - groin (open) | 1-10 |
| Hernia repair (minimally invasive) | 13 |
| Upper gastrointestinal (GI) endoscopy for acid reflux | 1-10 |
| Melanoma (skin cancer) excision | 1-10 |
| Removal of tissue | 1-10 |
| Removal of skin lesions | 1-10 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MS
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20101104001624 | MS | Practitioner - General Surgery | 0345434171 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 15891 | MS | MD | Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Singing River Gulfport | Current |
Accepting new patients | |
| Singing River Health System | Current |
Accepting new patients | |
| George County Hospital | Current | Accepting new patients | |
| Singing River Gulfport | Current |
Accepting new patients | |
| Singing River Health System | Past | Accepting new patients |
Locations
350 Cowan Rd
Gulfport, MS 39507
Phone (228) 206-7054
1124 Oakleigh Rd
Ocean Springs, MS 39564
Phone (228) 875-3778
2525 Telephone Rd
Pascagoula, MS 39567
Phone (228) 762-4483
Interoperability endpoints
- edwarddvorak@grh.medalliesdirect.net
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | 15891 | MS | Yes |
Addresses
Primary practice location
2525 Telephone Rd
Pascagoula, MS 39567
Mailing address
2525 Telephone Rd
Pascagoula, MS 39567
Phone (228) 762-4483
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00339814 | Medicaid | MS | |
| P00054513 | Other | MS | RAILROAD MEDICARE |
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | edvorak4449@direct.mysrhs.com | Health Information Exchange (HIE) |
Other providers in Pascagoula, MS
- Jenna Kay Drennen
- Nakisha Delynn Ducksworth
- Maggie Emerson Duke
- Samantha Nicole Dupree
- Dva Healthcare Renal Care Inc
- Edward Brown Specialty Partners of Mississippi, PLLC
- Kendra Edwards
- John Chester Egbert
- William R Ehlert
- Okechukwu Ekenna
All providers in Pascagoula, MS · Surgery Physician in Mississippi
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 2, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.