TUPELO PLASTIC SURGERY CLINIC OF TUPELO PA
NPI 1649381104
Plastic Surgery in Tupelo, MS
About Tupelo Plastic Surgery Clinic Of Tupelo Pa NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
TUPELO PLASTIC SURGERY CLINIC OF TUPELO PA (NPI 1649381104) is a healthcare organization registered as a plastic surgery in Tupelo, Mississippi and active in the NPI registry since August 2006. The organization lists Robert Buckley, Md, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Identifiers 1
Group Practice 1
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)
Tupelo Plastic Surgery Clinic Of Tupelo Pa 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.
Clinicians Billing Medicare Through This Organization
Medicare enrollment records show 1 clinician reassigns Medicare billing to Tupelo Plastic Surgery Clinic Of Tupelo PA, which bills Medicare for the services this clinician delivers.
Clinician (1)
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 Tupelo Plastic Surgery Clinic Of Tupelo PA's NPI number?
The NPI number for Tupelo Plastic Surgery Clinic Of Tupelo PA is 1649381104. It was assigned to this organization in the NPPES registry on August 31, 2006.
Where is Tupelo Plastic Surgery Clinic Of Tupelo PA located?
Tupelo Plastic Surgery Clinic Of Tupelo PA is located at 4381 S Eason Blvd Ste 101 Longtown Medical Park, Tupelo, MS 38801. The listed phone number is (662) 377-6630.
What is Tupelo Plastic Surgery Clinic Of Tupelo PA's specialty?
The primary specialty registered for this NPI is Plastic Surgery with taxonomy code 208200000X.
Is Tupelo Plastic Surgery Clinic Of Tupelo PA enrolled in Medicare?
Yes. Tupelo Plastic Surgery Clinic Of Tupelo PA is registered in the Medicare PECOS enrollment system.
When is Tupelo Plastic Surgery Clinic Of Tupelo PA'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 Tupelo Plastic Surgery Clinic Of Tupelo PA?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Plastic and Reconstructive Surgery) reassigns their Medicare billing to Tupelo Plastic Surgery Clinic Of Tupelo PA. 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.
When was this NPI record last updated?
The NPPES record for Tupelo Plastic Surgery Clinic Of Tupelo PA was last updated on February 29, 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.
# Tupelo Plastic Surgery Clinic Of Tupelo Pa · NPI 1649381104
Plastic Surgery organization in Tupelo, Mississippi. Organization record, active in the CMS NPPES registry since August 31, 2006.
## Identity
- **NPI:** 1649381104 (Entity type: Organization)
- **Enumerated:** August 31, 2006
- **Primary specialty:** Plastic Surgery · taxonomy 208200000X
- **Organization subpart:** No
- **Authorized official:** Robert Buckley, MD
## Practice location
- **Address:** 4381 S EASON BLVD STE 101, LONGTOWN MEDICAL PARK, Tupelo, MS 38801-6586
- **Phone:** (662) 377-6630 · **Fax:** (662) 377-6635
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Medicare revalidation due:** December 31, 2026 (Non-DME Part B, Mississippi, Clinic/Group Practice) · CMS Revalidation Due Date List, October 2026 release
- **Clinicians billing through this organization:** 1 clinician (Plastic and Reconstructive Surgery) reassigns Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** February 29, 2008
- **Other identifiers:** Medicaid 00110707 (MS)
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Source: [NPI Profile](https://npiprofile.com/npi/1649381104) · Data from the CMS NPPES public registry.