Gulfport Obgyn Clinic, Llc - Medicare Primary Care in Gulfport, MS

  1. Home
  2. Primary Care Clinics
  3. MS
  4. Gulfport
Gulfport Obgyn Clinic, Llc is a medicare enrolled primary clinic (Clinic/center) in Gulfport, Mississippi. The current practice location for Gulfport Obgyn Clinic, Llc is 4502 Old Pass Rd, Gulfport, Mississippi. For appointments, you can reach them via phone at (228) 863-9977. The mailing address for Gulfport Obgyn Clinic, Llc is 4502 Old Pass Rd, Gulfport, Mississippi and phone number is (228) 863-9977.

Gulfport Obgyn Clinic, Llc is licensed to practice in * (Not Available) (license number ). The clinic also participates in the medicare program and its NPI number is 1902635071. This medical practice accepts medicare insurance (which means this clinic accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance). However, please confirm if they accept your insurance at (228) 863-9977.

Contact Information

Gulfport Obgyn Clinic, Llc
4502 Old Pass Rd
Gulfport
MS 39501-2585
(228) 863-9977
(228) 863-9912

Map and Direction


Primary Care Clinic Profile

Full NameGulfport Obgyn Clinic, Llc
SpecialityClinic/Center
Location4502 Old Pass Rd, Gulfport, Mississippi
Authorized Official Name and PositionSydney Gruich (OFFICE MANAGER)
Authorized Official Contact2288639977
Accepts Medicare InsuranceYes. This clinic participates in medicare program and accept medicare insurance.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Gulfport Obgyn Clinic, Llc
4502 Old Pass Rd
Gulfport
MS 39501-2585

Ph: (228) 863-9977		Gulfport Obgyn Clinic, Llc
4502 Old Pass Rd
Gulfport
MS 39501-2585

Ph: (228) 863-9977

NPI Details:

NPI Number1902635071
Provider Enumeration Date07/29/2024
Last Update Date07/30/2024

Medicare PECOS Information:

Medicare PECOS PAC ID4587103221
Medicare Enrollment IDO20240827000820

Medical Identifiers

Medical identifiers for Gulfport Obgyn Clinic, Llc such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1902635071NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
261Q00000XClinic/center (* (Not Available))Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Gulfport Obgyn Clinic, Llc acts as a billing entity for following providers:
Provider NameHolly Summerlin
Provider TypePractitioner - Obstetrics/gynecology
Provider IdentifiersNPI Number: 1508843772
PECOS PAC ID: 5294795423
Enrollment ID: I20041013000095
Provider NameDonald K Gaddy
Provider TypePractitioner - Obstetrics/gynecology
Provider IdentifiersNPI Number: 1659358869
PECOS PAC ID: 7315948163
Enrollment ID: I20070514000383
Provider NameJohn F Pappas
Provider TypePractitioner - Obstetrics/gynecology
Provider IdentifiersNPI Number: 1558460162
PECOS PAC ID: 0143304832
Enrollment ID: I20101214000678
Provider NameEniola O Fagbongbe
Provider TypePractitioner - Obstetrics/gynecology
Provider IdentifiersNPI Number: 1790737807
PECOS PAC ID: 9739130972
Enrollment ID: I20221121000114
Provider NameAdela M Narcisse
Provider TypePractitioner - Obstetrics/gynecology
Provider IdentifiersNPI Number: 1891972410
PECOS PAC ID: 3678646312
Enrollment ID: I20230822001117
Provider NameJonathan D Jones
Provider TypePractitioner - Obstetrics/gynecology
Provider IdentifiersNPI Number: 1083175251
PECOS PAC ID: 1759612807
Enrollment ID: I20230831002986
Provider NameBlake Landry
Provider TypePractitioner - Obstetrics/gynecology
Provider IdentifiersNPI Number: 1417953597
PECOS PAC ID: 8729158092
Enrollment ID: I20231114000668
Provider NameErna A Waxman
Provider TypePractitioner - Obstetrics/gynecology
Provider IdentifiersNPI Number: 1487637617
PECOS PAC ID: 6901091867
Enrollment ID: I20231218003993
Provider NameErin L Fairbrother
Provider TypePractitioner - Obstetrics/gynecology
Provider IdentifiersNPI Number: 1053601526
PECOS PAC ID: 0345554424
Enrollment ID: I20240213000929
Provider NameIan Nguyen
Provider TypePractitioner - Obstetrics/gynecology
Provider IdentifiersNPI Number: 1144489691
PECOS PAC ID: 6406007020
Enrollment ID: I20240930001190

Reviews and Comments


Clinic/Center in Gulfport, MS


Primary Care Clinic
Medicare: Not Enrolled in Medicare
Practice Location: 12057 Highway 49 Ste C, Gulfport, MS 39503
Phone: 228-832-9385    Fax: 877-504-6444
My Brother's Keeper, Inc
Primary Care Clinic
Medicare: Not Enrolled in Medicare
Practice Location: 1221 Bridge St, Gulfport, MS 39507
Phone: 769-216-2455    
The Healing Hub
Primary Care Clinic
Medicare: Not Enrolled in Medicare
Practice Location: 1520 29th Ave Ste 26, Gulfport, MS 39501
Phone: 228-380-0662    
Children's International, Llc
Primary Care Clinic
Medicare: Medicare Enrolled
Practice Location: 15465 Oak Ln, Gulfport, MS 39503
Phone: 228-831-8800    Fax: 228-831-8020

Primary Care Clinic
Medicare: Not Enrolled in Medicare
Practice Location: 15024 Martin Luther King Jr Blvd, Gulfport, MS 39501
Phone: 228-864-0003    Fax: 228-374-0856
Gulf Coast Endocrinology
Primary Care Clinic
Medicare: Not Enrolled in Medicare
Practice Location: 4540 W Railroad St, Gulfport, MS 39501
Phone: 228-867-6062    Fax: 228-867-2598

Primary Care Clinic
Medicare: Not Enrolled in Medicare
Practice Location: 12261 Highway 49, Suite 11 F, Gulfport, MS 39503
Phone: 228-867-5185    Fax: 228-867-5186

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.