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ROBERT JOSEPH DERVELOY M.D. NPI 1689674707


NPI Information

NPI: 1689674707
Provider Name: ROBERT JOSEPH DERVELOY, M.D.
Classification: Thoracic Surgery (Cardiothoracic Vascular Surgery) - 208G00000X
Entity Type: Individual
Organization: NORTH MISSISSIPPI MEDICAL CENTER INC

PECOS Registration: Yes

Address:
830 S GLOSTER ST
NMMC EAST TOWER 4TH FLOOR
TUPELO, MS
ZIP 38801
Phone: (662) 377-7170
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Robert Joseph Derveloy, M.D. is a thoracic surgery cardiothoracic vascular surgery in Tupelo, MS with 46 years of experience. The provider is 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. Robert Joseph Derveloy, M.D. NPI is 1689674707. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: LOUISIANA STATE UNIVERSITY SCHOOL OF MEDICINE IN NEW ORLEANS
Graduation Year:1978

The provider's business location address is:

830 S GLOSTER ST
NMMC EAST TOWER 4TH FLOOR
TUPELO, MS
ZIP 38801-934
Phone: (662) 377-7170
Fax: (662) 377-2423

The NPI 1689674707 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Harvest of veins for coronary artery bypass procedure using an endoscope (HCPCS:33508)
  • Heart artery bypass to repair one artery (HCPCS:33533)
  • Combined multiple vein and artery heart artery bypasses (HCPCS:33519)
  • Combined multiple vein and artery heart artery bypasses (HCPCS:33518)

The enumeration date for this NPI number is 7/29/2005 and was last updated on 7/8/2007.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1208G00000XThoracic Surgery (Cardiothoracic Vascular Surgery)12390MISSISSIPPIYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
100118384MEDICAIDMISSISSIPPI
2730-10331OTHERALABAMABCBS
3E32942MEDICARE UPIN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.