Active NPI
Scott S Paladichuk, O.D.
- Optometrist
- Hattiesburg, MS
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 829
- Practice address
- 100 Hospital Dr W
Hattiesburg, MS 39402-1334 - Phone
- (601) 268-5910
- Fax
- (601) 264-0659
- NPI assigned
- Jan 16, 2009
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Optometrist | 152W00000X | 2895 | TN | |
| Optometrist | 152W00000X | 829 | MS | Primary |
Addresses
Primary practice location
100 Hospital Dr W
Hattiesburg, MS 39402-1334
Mailing address
100 Hospital Dr W
Hattiesburg, MS 39402-1334
Phone (601) 268-5910
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1160823 | Other | MS | CIGNA |
| 9036592 | Other | MS | AETNA |
| 00154827 | Medicaid | MS | |
| 6041813 | Other | MS | HEALTHSPRING |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MS
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Optometry
- Education
- Southern College of Optometry, 2009
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
100 Hospital Dr W
Hattiesburg, MS 39402-1334
Phone (601) 268-5910
Merit-based Incentive Payment System (MIPS)
- Final score
- 81.78 of 100
- Quality
- 89.54
- Improvement activities
- 40
- Cost
- 53.22
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2895 | TN | MD | Chiropractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Hattiesburg Eye Clinic, P.a. | Optometrist | Current | Accepting new patients |
| Hattiesburg Eye Clinic, P.a. | Optometrist | Current | Accepting new patients |
| Childrens Hospital of Wisconsin, Inc. | Past | Accepting new patients |
Locations
1001 Highway 98 Byp
Columbia, MS 39429
Phone (601) 620-0470
426 Broad St
Columbia, MS 39429
100 Hospital Dr W
Hattiesburg, MS 39402
Phone (601) 268-5910
1711 W 20th St
Laurel, MS 39440
Phone (650) 660-1649
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.
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- Milwaukee, WI
- NPI 1245308626
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1232064000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1420416000000",
"number": "1962649657",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "100 HOSPITAL DR W",
"city": "HATTIESBURG",
"state": "MS",
"postal_code": "394021334",
"telephone_number": "601-268-5910",
"fax_number": "601-264-0659"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 HOSPITAL DR W",
"city": "HATTIESBURG",
"state": "MS",
"postal_code": "394021334",
"telephone_number": "601-268-5910",
"fax_number": "601-264-0659"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PALADICHUK",
"first_name": "SCOTT",
"middle_name": "S",
"credential": "O.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2009-01-16",
"last_updated": "2015-01-05",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "TN",
"license": "2895",
"primary": false
},
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "MS",
"license": "829",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA",
"identifier": "1160823",
"state": "MS"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "9036592",
"state": "MS"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00154827",
"state": "MS"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTHSPRING",
"identifier": "6041813",
"state": "MS"
}
],
"endpoints": [],
"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 Jan 5, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- 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.