Official registry information on file with the National Plan and Provider Enumeration System.
DR. PARVEZ KARIM M.D. (NPI 1275562464) is an individual internal medicine provider in Greenville, Mississippi, licensed in Mississippi (14161) and active in the NPI registry since July 2006. He is enrolled in Medicare PECOS, is affiliated with University Of Mississippi Med Center, and is a graduate of Other (1994).
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
Medicare ID-Type Unspecified110001447MS · Medicare Prov Number
Medicare UPING00122MS
Accepted Insurance
The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter from Magnolia Health and more.Insurance ›
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.
Medicare Enrollment Status
✔
Enrolled in Medicare and accepts Medicare assignment
Dr. Parvez Karim M.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.
PECOS PAC ID9739167024
PECOS Enrollment IDI20040713000199
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.
Areas of Expertise CMS Part B claims12
Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.
Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes 99233
Follow-up hospital inpatient care per day typically involves a 35-minute check-up by your healthcare provider. This service includes monitoring your health progress, adjusting your treatment plan if needed, and answering any questions you may have about your condition or care.
1,709 services275 patients
Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232
Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.
624 services56 patients
Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes 99222
Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.
403 services296 patients
Hospital discharge day management, 30 minutes or less 99238
Hospital discharge day management of 30 minutes or less includes finalizing your treatment, discussing your progress, and planning after-care at home. It ensures you're ready to leave the hospital and continue recovery safely.
309 services234 patients
Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
261 services122 patients
Blood glucose (sugar) test performed by hand-held instrument 82962
A blood glucose test uses a handheld device to measure the amount of sugar in your blood. A small prick on your finger allows a drop of blood to be placed on a test strip, which is then read by the device. This helps monitor and manage diabetes effectively.
103 services50 patients
Hemoglobin a1c level, by device for home use 83037
A Hemoglobin A1c device for home use allows you to check your average blood sugar levels over the past 3 months. It's a simple, painless test that provides immediate results, helping you manage your diabetes more effectively.
99 services48 patients
Removal of skin and tissue, 20.0 sq cm or less 11042
This procedure involves the surgical removal of skin and tissue, up to 20.0 square cm in size. It's often performed to treat conditions like skin cancer or to remove moles, warts, and other skin lesions. The area is numbed and the unwanted tissue is carefully cut out.
61 services23 patients
Removal of tissue from wound, 20.0 sq cm or less 97597
This procedure involves the careful removal of damaged or infected tissue from a wound that's 20.0 square cm or less. It's done to promote healing and prevent further infection. The process is carried out under local anesthesia, ensuring minimal discomfort.
33 services11 patients
Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
28 services21 patients
New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204
This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.
13 services13 patients
New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204
This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.
12 services12 patients
Hospital Affiliations CMS Care Compare5
Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.
Location1401 River RdGreenwood, MS 38930 · Leflore County
✓ Emergency services
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 38703 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
New Patient
$120.41 typical visit price
range $51.65 – $159.18
Typical copayment $30.10(range $12.91 – $39.79)
Most-billed visit code 99204
Established Patient
$92.20 typical visit price
range $16.15 – $129.61
Typical copayment $23.05(range $4.03 – $32.40)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.
Medicare Quality Performance CMS QPP · MIPS
Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.
75/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Individually scored
Reported Quality Measures
Breast Cancer Screening
Percentage of women 50-74 years of age who had a mammogram to screen for breast cancer
25%258 patients★★★★★2/55-star benchmark: 92%
Cervical Cancer Screening
Percentage of women 21-64 years of age who were screened for cervical cancer using either of the following criteria: - Women age 21-64 who had cervical cytology performed every 3 years - Women age 30-64 who had cervical cytology/human papillomavirus (HPV)…
2%198 patients
Colorectal Cancer Screening
Percentage of adults 50-75 years of age who had appropriate screening for colorectal cancer
36%434 patients★★★★★2/55-star benchmark: 85%
Diabetes: Medical Attention for Nephropathy
The percentage of patients 18-75 years of age with diabetes who had a nephropathy screening test or evidence of nephropathy during the measurement period
85%203 patients★★★★★4/55-star benchmark: 99%
Documentation of Current Medications in the Medical Record
Percentage of visits for patients aged 18 years and older for which the eligible professional or eligible clinician attests to documenting a list of current medications using all immediate resources available on the date of the encounter.
100%1,515 patients★★★★★5/55-star benchmark: 100%
e-Prescribing
At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.
99%3,969 patients★★★★★5/55-star benchmark: 99%
Patient-Specific Education
The MIPS eligible clinician must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide access to those materials to at least one unique patient seen by the MIPS eligible clinician.
24%687 patients★★★★★2/55-star benchmark: 97%
Pneumococcal Vaccination Status for Older Adults
Percentage of patients 65 years of age and older who have ever received a pneumococcal vaccine
1%338 patients★★★★★1/55-star benchmark: 90%
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan
Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the previous twelve months AND with a BMI outside of normal parameters, a follow-up plan is documented during the encounter or during the previous…
16%690 patients★★★★★1/55-star benchmark: 97%
Preventive Care and Screening: Influenza Immunization
Percentage of patients aged 6 months and older seen for a visit between October 1 and March 31 who received an influenza immunization OR who reported previous receipt of an influenza immunization
2%470 patients★★★★★1/55-star benchmark: 88%
Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention
Percentage of patients aged 18 years and older who were screened for tobacco use one or more times within 24 months AND who received tobacco cessation intervention if identified as a tobacco user
Patients screenedForUse: 93% · 533 patients
Patients tobacco: 78% · 533 patients
4%113 patients★★★★★1/55-star benchmark: 98%
Provide Patient Access
At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician's discretion to withhold…
1%687 patients★★★★★1/55-star benchmark: 100%
Statin Therapy for the Prevention and Treatment of Cardiovascular Disease
Percentage of the following patients - all considered at high risk of cardiovascular events - who were prescribed or were on statin therapy during the measurement period: - Adults aged >= 21 years who were previously diagnosed with or currently have an active…
69%175 patients★★★★★3/55-star benchmark: 89%
Use of High-Risk Medications in the Elderly
Percentage of patients 65 years of age and older who were ordered high-risk medications. Two rates are submitted. 1) Percentage of patients who were ordered at least one high-risk medication.
Lower rates are better for this measure.
Patients 2+: 2% · 338 patients
3%338 patients★★★★★4/55-star benchmark: 100%
Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.
Referred Medical Equipment & Supplies CMS DME claims54
Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.
Replacement battery, alkaline (other than j cell), for use with medically necessary home blood glucose monitor owned by patient, each A4233
DME-Other DME · category DE017N
2 suppliers11 claims22 services$0.44 avg. paid by Medicare
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253
DME-Other DME · category DE017N
10 suppliers64 claims176 services$6.52 avg. paid by Medicare
Normal, low and high calibrator solution / chips A4256
DME-Other DME · category DE000N
3 suppliers31 claims31 services$2.84 avg. paid by Medicare
Spring-powered device for lancet, each A4258
DME-Other DME · category DE000N
1 supplier13 claims13 services$1.83 avg. paid by Medicare
Lancets, per box of 100 A4259
DME-Medical/Surgical Supplies · category DA000N
7 suppliers44 claims62 services$1.18 avg. paid by Medicare
Insertion tray with drainage bag with indwelling catheter, foley type, two-way latex with coating (teflon, silicone, silicone elastomer or hydrophilic, etc.) A4314
DME-Orthotic Devices · category DF000N
3 suppliers13 claims13 services$20.79 avg. paid by Medicare
Urinary catheter anchoring device, adhesive skin attachment, each A4333
DME-Orthotic Devices · category DF000N
2 suppliers24 claims288 services$2.05 avg. paid by Medicare
Bedside drainage bag, day or night, with or without anti-reflux device, with or without tube, each A4357
DME-Orthotic Devices · category DF000N
2 suppliers25 claims30 services$7.46 avg. paid by Medicare
Ostomy pouch, closed, with barrier attached, with filter (1 piece), each A4416
DME-Orthotic Devices · category DF010N
1 supplier23 claims1,320 services$2.61 avg. paid by Medicare
Tape, non-waterproof, per 18 square inches A4450
DME-Medical/Surgical Supplies · category DA000N
1 supplier16 claims1,320 services$0.10 avg. paid by Medicare
Tape, waterproof, per 18 square inches A4452
DME-Medical/Surgical Supplies · category DA000N
3 suppliers15 claims2,204 services$0.37 avg. paid by Medicare
Appliance cleaner, incontinence and ostomy appliances, per 16 oz. A5131
DME-Orthotic Devices · category DF000N
1 supplier14 claims14 services$15.30 avg. paid by Medicare
Collagen based wound filler, dry form, sterile, per gram of collagen A6010
DME-Medical/Surgical Supplies · category DA023N
3 suppliers20 claims870 services$29.81 avg. paid by Medicare
Collagen dressing, sterile, size 16 sq. in. or less, each A6021
DME-Medical/Surgical Supplies · category DA023N
4 suppliers46 claims1,581 services$20.22 avg. paid by Medicare
Alginate or other fiber gelling dressing, wound cover, sterile, pad size 16 sq. in. or less, each dressing A6196
DME-Medical/Surgical Supplies · category DA023N
3 suppliers54 claims2,564 services$7.05 avg. paid by Medicare
Alginate or other fiber gelling dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., each dressing A6197
DME-Medical/Surgical Supplies · category DA023N
3 suppliers22 claims1,317 services$15.85 avg. paid by Medicare
Foam dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing A6212
DME-Medical/Surgical Supplies · category DA023N
3 suppliers22 claims414 services$9.11 avg. paid by Medicare
Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing A6219
DME-Medical/Surgical Supplies · category DA023N
3 suppliers37 claims1,626 services$0.90 avg. paid by Medicare
Gauze, impregnated with other than water, normal saline, or hydrogel, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing A6222
DME-Medical/Surgical Supplies · category DA023N
5 suppliers15 claims498 services$2.05 avg. paid by Medicare
Hydrogel dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing A6243
DME-Medical/Surgical Supplies · category DA023N
2 suppliers14 claims570 services$11.87 avg. paid by Medicare
Hydrogel dressing, wound filler, gel, per fluid ounce A6248
DME-Medical/Surgical Supplies · category DA023N
3 suppliers21 claims67 services$15.61 avg. paid by Medicare
Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing A6402
DME-Medical/Surgical Supplies · category DA023N
2 suppliers22 claims1,550 services$0.11 avg. paid by Medicare
Conforming bandage, non-elastic, knitted/woven, sterile, width greater than or equal to three inches and less than five inches, per yard A6446
DME-Medical/Surgical Supplies · category DA023N
4 suppliers26 claims3,192 services$0.38 avg. paid by Medicare
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable A7003
DME-Other DME · category DE000N
2 suppliers18 claims36 services$2.02 avg. paid by Medicare
Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable A7005
DME-Other DME · category DE000N
5 suppliers12 claims12 services$17.04 avg. paid by Medicare
Filter, disposable, used with positive airway pressure device A7038
DME-Other DME · category DE001N
2 suppliers15 claims51 services$3.08 avg. paid by Medicare
Enteral feeding supply kit; syringe fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape B4034
Other-Enteral and Parenteral · category OB006N
3 suppliers12 claims344 services$3.68 avg. paid by Medicare
Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape B4035
Other-Enteral and Parenteral · category OB006N
5 suppliers67 claims1,571 services$7.53 avg. paid by Medicare
Enteral formula, nutritionally complete with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit B4150
Other-Enteral and Parenteral · category OB006N
2 suppliers13 claims5,119 services$0.42 avg. paid by Medicare
Enteral formula, nutritionally complete, calorically dense (equal to or greater than 1.5 kcal/ml) with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit B4152
Other-Enteral and Parenteral · category OB006N
4 suppliers19 claims10,973 services$0.33 avg. paid by Medicare
Enteral formula, nutritionally complete, for special metabolic needs, excludes inherited disease of metabolism, includes altered composition of proteins, fats, carbohydrates, vitamins and/or minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit B4154
Other-Enteral and Parenteral · category OB006N
4 suppliers53 claims19,242 services$0.84 avg. paid by Medicare
Walker, heavy duty, wheeled, rigid or folding, any type E0149
DME-Other DME · category DE000N
2 suppliers12 claims12 services$2.77 avg. paid by Medicare
Commode chair, mobile or stationary, with detachable arms E0165
DME-Other DME · category DE000N
2 suppliers13 claims13 services$11.15 avg. paid by Medicare
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress E0260
DME-Hospital Beds · category DB000N
3 suppliers86 claims86 services$68.09 avg. paid by Medicare
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, without mattress E0261
DME-Hospital Beds · category DB000N
1 supplier29 claims29 services$65.52 avg. paid by Medicare
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing E0431
DME-Oxygen and Supplies · category DC000N
7 suppliers54 claims54 services$18.34 avg. paid by Medicare
Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell) E0466
DME-Other DME · category DE005N
1 supplier17 claims17 services$771.46 avg. paid by Medicare
Nebulizer, with compressor E0570
DME-Other DME · category DE000N
5 suppliers42 claims42 services$7.92 avg. paid by Medicare
Respiratory suction pump, home model, portable or stationary, electric E0600
DME-Other DME · category DE000N
2 suppliers18 claims18 services$28.29 avg. paid by Medicare
Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s) E0630
DME-Other DME · category DE000N
2 suppliers13 claims13 services$54.84 avg. paid by Medicare
Iv pole E0776
DME-Other DME · category DE000N
2 suppliers22 claims22 services$13.83 avg. paid by Medicare
Trapeze bars, a/k/a patient helper, attached to bed, with grab bar E0910
DME-Other DME · category DE000N
2 suppliers18 claims18 services$10.30 avg. paid by Medicare
Manual wheelchair accessory, anti-tipping device, each E0971
DME-Wheelchairs · category DD021N
2 suppliers44 claims79 services$2.94 avg. paid by Medicare
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390
DME-Oxygen and Supplies · category DC002N
7 suppliers119 claims120 services$108.22 avg. paid by Medicare
Portable oxygen concentrator, rental E1392
DME-Oxygen and Supplies · category DC002N
1 supplier15 claims15 services$38.12 avg. paid by Medicare
Arformoterol, inhalation solution, fda approved final product, non-compounded, administered through dme, unit dose form, 15 micrograms J7605
DME-Drugs Administered Through DME · category DG006N
1 supplier12 claims720 services$4.41 avg. paid by Medicare
Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg J7613
DME-Drugs Administered Through DME · category DG006N
3 suppliers18 claims3,761 services$0.03 avg. paid by Medicare
Albuterol, up to 2.5 mg and ipratropium bromide, up to 0.5 mg, fda-approved final product, non-compounded, administered through dme J7620
DME-Drugs Administered Through DME · category DG006N
2 suppliers35 claims2,550 services$0.10 avg. paid by Medicare
Budesonide, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, up to 0.5 mg J7626
DME-Drugs Administered Through DME · category DG000N
1 supplier12 claims600 services$0.80 avg. paid by Medicare
Standard wheelchair K0001
DME-Wheelchairs · category DD000N
6 suppliers74 claims74 services$25.16 avg. paid by Medicare
Lightweight wheelchair K0003
DME-Wheelchairs · category DD000N
1 supplier16 claims16 services$34.38 avg. paid by Medicare
Elevating leg rests, pair (for use with capped rental wheelchair base) K0195
DME-Wheelchairs · category DD021N
2 suppliers25 claims25 services$10.49 avg. paid by Medicare
Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service K0553
DME-Other DME · category DE017N
3 suppliers17 claims17 services$200.20 avg. paid by Medicare
Pharmacy dispensing fee for inhalation drug(s); per 30 days Q0513
DME-Other DME · category DE000N
4 suppliers58 claims58 services$25.01 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.
Other Providers at the Same Location NPPES4
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Parvez Karim's NPI number?
The NPI number for Parvez Karim is 1275562464. It was assigned to this individual provider in the NPPES registry on July 1, 2006.
Where is Parvez Karim located?
Parvez Karim practices at 1504 Hospital St, Greenville, MS 38703. The listed phone number is (662) 378-9929.
What is Parvez Karim's specialty?
The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.
Is Parvez Karim enrolled in Medicare?
Yes. Parvez Karim is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
What insurance does Parvez Karim accept?
Health plans from Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter from Magnolia Health, Ambetter of Alabama and Ambetter of Tennessee and 5 other insurers list Parvez Karim as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
Is Parvez Karim affiliated with any hospitals?
According to CMS data, Parvez Karim is affiliated with University Of Mississippi Med Center, St Dominic-Jackson Memorial Hospital, Delta Health System - The Medical Center, Bolivar Medical Center and Greenwood Leflore Hospital.
When was this NPI record last updated?
The NPPES record for Parvez Karim was last updated on November 30, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Dr. Parvez Karim, M.D. · NPI 1275562464
Internal Medicine physician in Greenville, Mississippi. Individual provider, active in the CMS NPPES registry since July 1, 2006.
## Identity
- **NPI:** 1275562464 (Entity type: Individual)
- **Enumerated:** July 1, 2006
- **Primary specialty:** Internal Medicine · taxonomy 207R00000X
- **State license:** 14161 (Mississippi)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 1504 HOSPITAL ST, Greenville, MS 38703-3219
- **Phone:** (662) 378-9929 · **Fax:** (662) 378-9926
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Medical school:** Other, class of 1994
## Record status
- **NPPES last updated:** November 30, 2012
- **Other identifiers:** Medicaid 00114839 (MS); Medicare ID-Type Unspecified 110001447 (MS); Medicare UPIN G00122 (MS)
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Source: [NPI Profile](https://npiprofile.com/npi/1275562464) · Data from the CMS NPPES public registry.