NPIMap

Individual provider Active NPI

Joel A Tucker, M.D.

  • Adult Reconstructive Orthopaedic Surgery Physician
  • Biloxi, MS
National Provider Identifier
1912068677
Registry record updated Mar 22, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Reconstructive Orthopaedic Surgery PhysicianTaxonomy code 207XS0114X
License
21487 Issued in MS
Practice address
1720A Medical Park Dr
Suite 220
Biloxi, MS 39532-2129
Phone
(228) 392-9355
Fax
(228) 392-1781
NPI assigned
Dec 13, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 22, 2017

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X TRN9064 FL
Adult Reconstructive Orthopaedic Surgery Physician 207XS0114X ME106815 FL
Orthopaedic Surgery Physician 207X00000X 21487 MS
Adult Reconstructive Orthopaedic Surgery Physician 207XS0114X 21487 MS Primary

Addresses

Primary practice location

1720A Medical Park Dr
Suite 220
Biloxi, MS 39532-2129

Mailing address

6300 E Lake Blvd
Ste. 301
Vancleave, MS 39565-6770
Phone (228) 230-2663

Other identifiers 1

IdentifierTypeStateIssuer
002486000MedicaidFL

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
I20110823000481 MS Practitioner - Orthopedic Surgery 5395860175 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
University of Mississippi School of Medicine, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bienville Orthopaedic Specialists, LLCGroup PAC ID 0547155178, 43 clinicians

Practice addresses (Care Compare)

1720 A Medical Park Dr
Suite 220
Biloxi, MS 39532-2127
Phone (228) 392-9355

Hospital & facility affiliations

  • 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
  • Singing River Gulfport Hospital, Gulfport, MS, CCN 250123
  • Memorial Hospital Biloxi Hospital, Biloxi, MS, CCN 250007
  • Singing River Health System Hospital, Pascagoula, MS, CCN 250040

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hip replacement50
Knee replacement40
Lower limb (leg) arthroscopy (minimally invasive joint repair)1-10
Removal of tissue1-10
Removal of nail tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
TRN9064FLMDOrthopaedic Surgery Physician
21487MSMDOrthopaedic Surgery Physician
ME106815FLMDAdult Reconstructive Orthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Bienville Orthopaedic Specialists, LLC Orthopaedic Surgery CurrentSince Aug 22, 2011 Accepting new patients
Bienville Orthopaedic Specialists, LLC Orthopaedic Surgery CurrentSince Aug 22, 2011 Accepting new patients
Oal Care of Al, LLC Orthopaedic Surgery CurrentSince Jan 23, 2021 Accepting new patients

Locations

1720A Medical Park Dr
Ste 220
Biloxi, MS 39532
Phone (228) 392-9355

15476 Dedeaux Rd
#B
Gulfport, MS 39503
Phone (228) 679-3001

6300 E Lake Blvd
Ste 201
Vancleave, MS 39565
Phone (228) 206-2263

6300 E Lake Blvd
Ste 301
Vancleave, MS 39565

102 Woodmont Blvd
Ste 350
Nashville, TN 37205
Phone (615) 297-1020

Organizations & group practices 3

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.

Hospital & facility affiliations 65

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

View all 65

NPI Registry JSON

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

{
    "created_epoch": "1165968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1490140800000",
    "number": "1912068677",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6300 E LAKE BLVD",
            "address_2": "STE. 301",
            "city": "VANCLEAVE",
            "state": "MS",
            "postal_code": "395656770",
            "telephone_number": "228-230-2663",
            "fax_number": "228-206-1192"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1720A MEDICAL PARK DR",
            "address_2": "SUITE 220",
            "city": "BILOXI",
            "state": "MS",
            "postal_code": "395322129",
            "telephone_number": "228-392-9355",
            "fax_number": "228-392-1781"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUCKER",
        "first_name": "JOEL",
        "middle_name": "A",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-13",
        "last_updated": "2017-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "FL",
            "license": "TRN9064",
            "primary": false
        },
        {
            "code": "207XS0114X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery",
            "state": "FL",
            "license": "ME106815",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "MS",
            "license": "21487",
            "primary": false
        },
        {
            "code": "207XS0114X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery",
            "state": "MS",
            "license": "21487",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002486000",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Biloxi, MS

Sources for this page

Verify at the official NPI Registry.