ROBERT JOSEPH DERVELOY III M.D.
NPI 1689674707
Thoracic Surgery (Cardiothoracic Vascular Surgery) in Tupelo, MS

Q: What is Robert Derveloy's NPI number?

The NPI number for Robert Derveloy is 1689674707. It was assigned to this individual provider in the NPPES registry on July 29, 2005.

Q: What is Robert Derveloy's specialty?

The primary specialty registered for this NPI is Thoracic Surgery (Cardiothoracic Vascular Surgery) with taxonomy code 208G00000X.

Q: When was this NPI record last updated?

The NPPES record for Robert Derveloy was last updated on July 13, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 months 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.

Active since July 29, 2005PECOS Enrolled

93.1/100

CMS Quality Rating

830 S GLOSTER ST, NMMC EAST TOWER 4TH FLOOR, TUPELO, MS 38801(662) 377-7170(662) 377-2423 Get Directions Write a Review

NPPES record last updated: July 13, 2026. Verified against the NPPES registry weekly; last sync: October 25, 2026.

On this page

About Robert Joseph Derveloy Iii M.d. NPPES

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

ROBERT JOSEPH DERVELOY III M.D. (NPI 1689674707) is an individual thoracic surgery (cardiothoracic vascular surgery) provider in Tupelo, Mississippi, licensed in Mississippi (12390) and active in the NPI registry since July 2005. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1689674707

Entity TypeIndividualMale

Primary Taxonomy208G00000X

Provider Legal NameROBERT JOSEPH DERVELOY IIICredential: M.D.

Location Address830 S GLOSTER ST, NMMC EAST TOWER 4TH FLOORTupelo, MS 38801-4934

Mailing AddressPo Box 7062Tupelo, MS 38802-7062 · (662) 377-7170 · Fax (662) 377-2423

Phone(662) 377-7170

Fax(662) 377-2423

Sole ProprietorNo

Enumeration DateJuly 29, 2005

Last NPPES UpdateJuly 13, 2026

✔ NPI 1689674707 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyThoracic Surgery (Cardiothoracic Vascular Surgery)Allopathic & Osteopathic Physicians

Taxonomy Code208G00000X

License✔ Licensed in MS · 12390

Definition

A thoracic surgeon provides the operative, perioperative and critical care of patients with pathologic conditions within the chest. Included is the surgical care of coronary artery disease, cancers of the lung, esophagus and chest wall, abnormalities of the trachea, abnormalities of the great vessels and heart valves, congenital anomalies, tumors of the mediastinum and diseases of the diaphragm. The management of the airway and injuries of the chest is within the scope of the specialty.

830 S GLOSTER ST, Tupelo, MS 38801

Open in Google Maps ↗

Other Identifiers 2

Other730-10331AL · Bcbs

Medicaid00118384MS

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Cigna Healthcare.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Robert Joseph Derveloy Iii M.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

Medicare Billing Reassignment

Medicare enrollment records show Robert Derveloy reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

North Mississippi Medical Center

Same address

Family

830 S GLOSTER ST, 1ST FLOOR EAST TOWER
Tupelo, MS 38801

Reassigned Medicare billing, Mississippi enrollment
581 clinicians in this Medicare group

NPI 1336328715 (662) 377-2500

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

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 38801 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

$159.18 typical visit price

range $51.65 – $159.18

Typical copayment $39.79 (range $12.91 – $39.79)

Most-billed visit code 99205

Established Patient

$64.96 typical visit price

range $16.15 – $129.61

Typical copayment $16.24 (range $4.03 – $32.40)

Most-billed visit code 99213

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.

93.1/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored through an Alternative Payment Model

Quality

83.08

Promoting Interoperability

Improvement Activities

Referred Medical Equipment & Supplies CMS DME claims 3

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing E0431

DME-Oxygen and Supplies · category DC000N

2 suppliers26 claims26 services$19.64 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

2 suppliers35 claims35 services$113.49 avg. paid by Medicare

Automatic external defibrillator, with integrated electrocardiogram analysis, garment type K0606

DME-Other DME · category DE013N

1 supplier11 claims11 services$2,159.46 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 NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

LAUREN ELIZABETH ABEL CRNA

Nurse Anesthetist, Certified Registered

830 S GLOSTER ST
TUPELO, MS 38801

Lee County (662) 377-4394

WESLEY B BRUCE

Nurse Practitioner (Family)

830 S GLOSTER ST
TUPELO, MS 38801

Lee County (662) 377-3000

DR. ROBERT CARSON KIRKSEY M.D.

Emergency Medicine

830 S GLOSTER ST
TUPELO, MS 38801

Lee County (866) 754-3852

NORTH MISSISSIPPI MEDICAL CENTER SERVICES LLC

Internal Medicine

830 S GLOSTER ST
TUPELO, MS 38801

Lee County (662) 377-4685

NORTH MISSISSIPPI MEDICAL CENTER INC

Thoracic Surgery (Cardiothoracic Vascular Surgery)

830 S GLOSTER ST, 4TH FLOOR EAST TOWER
TUPELO, MS 38801

Lee County (662) 377-7170

JENNIFER L TAYLOR FNP-BC

Nurse Practitioner (Family)

830 S GLOSTER ST
TUPELO, MS 38801

Lee County (205) 412-0585

KALISA MICKELL FNP

Nurse Practitioner (Family)

830 S GLOSTER ST
TUPELO, MS 38801

Lee County (662) 377-3000

JESSICA KATHRYN PIPPIN

Nurse Practitioner

830 S GLOSTER ST
TUPELO, MS 38801

Lee County (888) 731-7611

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 Derveloy's NPI number?

The NPI number for Robert Derveloy is 1689674707. It was assigned to this individual provider in the NPPES registry on July 29, 2005.

Where is Robert Derveloy located?

Robert Derveloy practices at 830 S Gloster St Nmmc East Tower 4th Floor, Tupelo, MS 38801. The listed phone number is (662) 377-7170.

What is Robert Derveloy's specialty?

The primary specialty registered for this NPI is Thoracic Surgery (Cardiothoracic Vascular Surgery) with taxonomy code 208G00000X.

Is Robert Derveloy enrolled in Medicare?

Yes. Robert Derveloy is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Robert Derveloy's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Robert Derveloy reassigns Medicare benefits to North Mississippi Medical Center (Tupelo, MS). The 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 Robert Derveloy's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Robert Derveloy accept?

Health plans from Cigna Healthcare list Robert Derveloy 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 Derveloy was last updated on July 13, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 months 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.