NPIMap

Individual provider Active NPI

Max Waldrup, MD

  • Emergency Medicine Physician
  • Biloxi, MS
National Provider Identifier
1922632173
Registry record updated Nov 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
32420 Issued in MS
Practice address
301 Fisher St
Biloxi, MS 39534-2508
Phone
(228) 376-0500
NPI assigned
Feb 26, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2023

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 35.143907 OH
Student in an Organized Health Care Education/Training Program 390200000X 35.143907 OH
Student in an Organized Health Care Education/Training Program 390200000X
Emergency Medicine Physician 207P00000X 32420 MS Primary

Addresses

Primary practice location

301 Fisher St
Biloxi, MS 39534-2508

Mailing address

3919 Hanshaw Rd
Ocean Springs, MS 39564-9458
Phone (734) 883-1949

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
I20231116001286 MS Practitioner - Emergency Medicine 3375972482 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Michigan State University College of Human Medicine, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mississippi Emergency Department Services PCGroup PAC ID 7113453960, 40 clinicians
Memorial Hospital at GulfportGroup PAC ID 2466524012, 473 clinicians

Practice addresses (Care Compare)

2809 Denny Ave
Pascagoula, MS 39581-5301
Phone (228) 809-5000

4500 13TH St
Gulfport, MS 39501-2515
Phone (228) 575-2902

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
32420MSMDEmergency Medicine Physician
35.143907OHMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Memorial Hospital at Gulfport Emergency Medicine CurrentSince Feb 6, 2024 Accepting new patients
Emergency Room Group LTD Emergency Medicine CurrentSince Nov 6, 2023 Accepting new patients
Mississippi Emergency Department Services PC Emergency Medicine CurrentSince Nov 26, 2024 Accepting new patients
Memorial Hospital at Gulfport Current Accepting new patients

Locations

4500 13th St
Gulfport, MS 39501
Phone (228) 236-3872

3109 Bienville Blvd
Ocean Springs, MS 39564
Phone (228) 818-1100

2809 Denny Ave
Pascagoula, MS 39581
Phone (228) 809-5000

Interoperability endpoints

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

Organizations & group practices 5

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": "1582675200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698969600000",
    "number": "1922632173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3919 HANSHAW RD",
            "city": "OCEAN SPRINGS",
            "state": "MS",
            "postal_code": "395649458",
            "telephone_number": "734-883-1949"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 FISHER ST",
            "city": "BILOXI",
            "state": "MS",
            "postal_code": "395342508",
            "telephone_number": "228-376-0500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALDRUP",
        "first_name": "MAX",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-02-26",
        "last_updated": "2023-11-03",
        "certification_date": "2023-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OH",
            "license": "35.143907",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "OH",
            "license": "35.143907",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MS",
            "license": "32420",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Biloxi, MS

Sources for this page

Verify at the official NPI Registry.