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ROBERT C MASTERSON DO PA INC
NPI 1427112630
Family Medicine in Vicksburg, MS

Active since December 21, 2006
1901 MISSION 66, VICKSBURG, MS 39180(601) 636-0097(601) 629-9969 Get Directions Write a Review

NPPES record last updated: June 17, 2008. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Robert C Masterson Do Pa Inc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ROBERT C MASTERSON DO PA INC (NPI 1427112630) is a healthcare organization registered as a family medicine in Vicksburg, Mississippi and active in the NPI registry since December 2006. The organization lists Robert C Masterson, President, as its authorized official.

NPPES Registry Identity

NPI1427112630
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameROBERT C MASTERSON DO PA INC
Location Address1901 MISSION 66Vicksburg, MS 39180-3711
Mailing Address1901 Mission 66Vicksburg, MS 39180-3711 · (601) 636-0097 · Fax (601) 629-9969
Phone(601) 636-0097
Fax(601) 629-9969
Organization SubpartNo
Authorized OfficialRobert C MastersonPresident · (601) 636-0097
Enumeration DateDecember 21, 2006
Last NPPES UpdateJune 17, 2008
✔ NPI 1427112630 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in MS · 14322
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
1901 MISSION 66, Vicksburg, MS 39180
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Other Identifiers 3

Medicaid00115208MS
Medicare UPINF82099MS
Medicare PINC03133MS

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

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 Health and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, revalidation and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Robert C Masterson Do Pa Inc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Medicare Revalidation Due Date

Revalidation due by December 31, 2026

Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.

StateEnrollment IDDue date
StateMississippiEnrollment IDO20040913000470Non-DME Part B · Clinic/Group PracticeDue dateDecember 31, 2026
Source: CMS Revalidation Due Date List, October 2026 release.

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Robert C Masterson Do PA Inc, which bills Medicare for the services this clinician delivers.

Clinician (1)

Robert Masterson, DO
Family Practice
NPI 1053358853
1901 MISSION 66
Vicksburg, MS 39180
(601) 636-8244
✔ PECOS✔ Accepts MedicareSame address

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Robert C Masterson Do PA Inc's NPI number?

The NPI number for Robert C Masterson Do PA Inc is 1427112630. It was assigned to this organization in the NPPES registry on December 21, 2006.

Where is Robert C Masterson Do PA Inc located?

Robert C Masterson Do PA Inc is located at 1901 Mission 66, Vicksburg, MS 39180. The listed phone number is (601) 636-0097.

What is Robert C Masterson Do PA Inc's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Robert C Masterson Do PA Inc enrolled in Medicare?

Yes. Robert C Masterson Do PA Inc is registered in the Medicare PECOS enrollment system.

When is Robert C Masterson Do PA Inc's Medicare revalidation due?

According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (Mississippi, Clinic/Group Practice) is due for revalidation by December 31, 2026. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.

How many clinicians bill Medicare through Robert C Masterson Do PA Inc?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Family Practice) reassigns their Medicare billing to Robert C Masterson Do PA Inc. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

What insurance does Robert C Masterson Do PA Inc accept?

Health plans from Ambetter Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter of Alabama and Ambetter of Tennessee list Robert C Masterson Do PA Inc 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.

When was this NPI record last updated?

The NPPES record for Robert C Masterson Do PA Inc was last updated on June 17, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 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.