Patrick D Dauphin, MD
Individual provider Active NPI Interventional Cardiology Physician · Hattiesburg, MS
NPI 1962866004 · NPPES record last updated Dec 4, 2024
Key facts
- NPI
- 1962866004
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Interventional Cardiology Physician 207RI0011X
- License
- 26912 (MS)
- Practice address
- 415 S 28TH Ave
Hattiesburg, MS 39401-7246 - Phone
- (601) 264-6000
- NPI assigned
- Apr 5, 2016
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 30
Hospital & facility affiliations 4
Medicare Care Compare profile
- Specialty
- Cardiovascular Disease (Cardiology)
- Education
- Other, 2016
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- FGH Physician Billing
Hattiesburg Clinic PA
Forrest County General Hospital
Practice addresses (Care Compare)
130 Highland Pkwy
Picayune, MS 39466-5574
415 S 28TH Ave
Hattiesburg, MS 39401-7246
Phone (601) 264-6000
6051 U S Hwy 49
Hattiesburg, MS 39401-7200
Phone (601) 288-4273
6051 US Hwy 49 S
Hattiesburg, MS 39401-7200
Phone (601) 288-7000
801 Goodyear Blvd
Picayune, MS 39466-3221
Phone (601) 749-0688
Hospital & facility affiliations
- Forrest General Hospital
- Highland Community Hospital
- South Central Reg Med Ctr
- Pearl River County Hospital
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Coronary angioplasty and stenting | 16 |
| Pacemaker insertion or repair | 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 |
|---|---|---|---|---|
| I20210720002316 | MS | Practitioner - Cardiovascular Disease (Cardiology) |
0941596654 | Reassigns benefits to 4 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1962866004 | MS | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Hattiesburg Clinic PA | Current |
Accepting new patients | |
| FGH Physician Billing | Current |
Accepting new patients | |
| State of Mississippi - University of Mississippi Medical Center | Current |
Accepting new patients | |
| Forrest County General Hospital | Current |
Accepting new patients | |
| State of Mississippi - University of Mississippi Medical Center | Current |
Accepting new patients | |
| Hattiesburg Clinic, PA | Current |
Accepting new patients | |
| Forrest County General Hospital | Current | Accepting new patients | |
| Forrest County General Hospital | Current |
Accepting new patients | |
| Forrest County General Hospital | Past | Accepting new patients |
Locations
6051 U S Highway 49
Hattiesburg, MS 39401
Phone (601) 288-2690
415 S 28th Ave
Hattiesburg, MS 39401
Phone (601) 261-3606
2500 N State St
Jackson, MS 39216
Phone (601) 815-4775
801 Goodyear Blvd
Picayune, MS 39466
Phone (601) 749-0688
Interoperability endpoints
- pdauphin113599@directpatientrecord.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 1962866004 | MS | |
| Interventional Cardiology Physician | 207RI0011X | 26912 | MS | Yes |
Addresses
Primary practice location
415 S 28TH Ave
Hattiesburg, MS 39401-7246
Mailing address
415 S 28TH Ave
Hattiesburg, MS 39401-7246
Phone (601) 264-6000
Other providers in Hattiesburg, MS
- Marie M Darby
- Nathan Chambers Darby
- Evan Henry Dart
- Mehjabeen Darugar
- Geralyn Datz
- David M. Perez, DMD, P.C.
- Susan K Davidson
- Shannon Davis Sims
- Allyson Davis
- Angela Anita Davis
All providers in Hattiesburg, MS · Interventional Cardiology 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 Dec 4, 2024. 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.