1. Home
  2. Directory
  3. Mississippi
  4. Tupelo
  5. Thoracic Surgery Cardiothoracic Vascular Surgery
  6. NPI Profile
Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

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

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: August 02, 2026.

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

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

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.

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
Quality83.08
Promoting Interoperability88
Improvement Activities40

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.

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 25 days 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.