NPIMap

Individual provider Active NPI

Angela Booth Wingfield, MD

  • Procedural Dermatology Physician
  • Gulfport, MS
National Provider Identifier
1962494294
Registry record updated Dec 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Procedural Dermatology PhysicianTaxonomy code 207NS0135X
License
1731 Issued in MS
Practice address
11295 E Taylor Rd
Gulfport, MS 39503-4197
Phone
(228) 864-3300
NPI assigned
Aug 23, 2005
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 12, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Procedural Dermatology Physician 207NS0135X 024878 LA
Procedural Dermatology Physician 207NS0135X 1731 MS Primary

Addresses

Primary practice location

11295 E Taylor Rd
Gulfport, MS 39503-4197

Mailing address

11295 E Taylor Rd
Gulfport, MS 39503-4197
Phone (228) 864-3300

Other practice location 1

703 Frontage Dr E
Wiggins, MS 39577-8362
Phone (228) 864-3300

Other practice location 2

116 Menge Ave Apt A
Pass Christian, MS 39571-4738
Phone (228) 586-9565

Other identifiers 2

IdentifierTypeStateIssuer
25D1013637OtherCLIA
00874879MedicaidMS

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
I20031208000384 MS Practitioner - Dermatology 5496651911 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Louisiana State University School of Medicine in New Orleans, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Dermatology Clinic, PLLCGroup PAC ID 8123129673, 8 clinicians

Practice addresses (Care Compare)

11295 E Taylor Rd
Gulfport, MS 39503-4197
Phone (228) 864-3300

Hospital & facility affiliations

  • Singing River Gulfport Hospital, Gulfport, MS, CCN 250123
  • Memorial Hospital at Gulfport Hospital, Gulfport, MS, CCN 250019

Merit-based Incentive Payment System (MIPS)

Final score
82.57 of 100Reported as group
Quality
74.41
Improvement activities
40
Cost
76.03

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1740
Removal or shaving of skin growth32
Skin biopsy276

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
024878LAMDProcedural Dermatology Physician
1731MSMDProcedural Dermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Skin in the Game, PLLC CurrentSince Jul 5, 2018 Accepting new patients
The Dermatology Clinic, PLLC CurrentSince Sep 1, 2003 Accepting new patients

Locations

6510 Highway 90
#C
Gautier, MS 39553
Phone (228) 372-8559

11295 E Taylor Rd
Gulfport, MS 39503
Phone (228) 864-3300

116 Menge Ave
Apt A
Pass Christian, MS 39571
Phone (228) 586-9565

703 Frontage Dr E
Wiggins, MS 39577
Phone (228) 864-3300

Interoperability endpoints

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

Organizations & group practices 2

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 61

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

View all 61

NPI Registry JSON

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

{
    "created_epoch": "1124755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670803200000",
    "number": "1962494294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11295 E TAYLOR RD",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "395034197",
            "telephone_number": "228-864-3300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11295 E TAYLOR RD",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "395034197",
            "telephone_number": "228-864-3300"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "703 Frontage Dr E",
            "address_purpose": "LOCATION",
            "city": "Wiggins",
            "state": "MS",
            "postal_code": "395778362",
            "country_code": "US",
            "telephone_number": "228-864-3300",
            "fax_number": "228-864-3333",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "116 Menge Ave Apt A",
            "address_purpose": "LOCATION",
            "city": "Pass Christian",
            "state": "MS",
            "postal_code": "395714738",
            "country_code": "US",
            "telephone_number": "228-586-9565",
            "fax_number": "228-586-9564",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WINGFIELD",
        "first_name": "ANGELA",
        "middle_name": "BOOTH",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-08-23",
        "last_updated": "2022-12-12",
        "certification_date": "2022-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207NS0135X",
            "taxonomy_group": "",
            "desc": "Dermatology, Procedural Dermatology",
            "state": "LA",
            "license": "024878",
            "primary": false
        },
        {
            "code": "207NS0135X",
            "taxonomy_group": "",
            "desc": "Dermatology, Procedural Dermatology",
            "state": "MS",
            "license": "1731",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA",
            "identifier": "25D1013637",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00874879",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gulfport, MS

Sources for this page

Verify at the official NPI Registry.