Robert Joseph Derveloy Iii, MD - Medicare Thoracic Surgery (Cardiothoracic Vascular Surgery) in Tupelo, MS

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Robert Joseph Derveloy Iii, MD is a medicare enrolled "Thoracic Surgery (cardiothoracic Vascular Surgery)" physician in Tupelo, Mississippi. His current practice location is 830 S Gloster St, Nmmc East Tower 4th Floor, Tupelo, Mississippi. You can reach out to his office (for appointments etc.) via phone at (662) 377-7170.

Robert Joseph Derveloy Iii is licensed to practice in Mississippi (license number 12390) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1689674707.

Contact Information

Robert Joseph Derveloy Iii, MD
830 S Gloster St, Nmmc East Tower 4th Floor,
Tupelo, MS 38801-4934
(662) 377-7170
(662) 377-2423

Map and Direction




Physician's Profile

Full NameRobert Joseph Derveloy Iii
GenderMale
SpecialityThoracic Surgery (cardiothoracic Vascular Surgery)
Location830 S Gloster St, Tupelo, Mississippi
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1689674707
  • Provider Enumeration Date: 07/29/2005
  • Last Update Date: 07/08/2007
  Medicare PECOS Information:
  • PECOS PAC ID: 9830233626
  • Enrollment ID: I20100217000310

Medical Identifiers

Medical identifiers for Robert Joseph Derveloy Iii such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1689674707NPI-NPPES
730-10331OtherALBCBS
00118384MedicaidMS

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
208G00000XThoracic Surgery (cardiothoracic Vascular Surgery) 12390 (Mississippi)Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Robert Joseph Derveloy Iii allows following entities to bill medicare on his behalf.
Entity NameNorth Mississippi Medical Center, Inc.
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1972608347
PECOS PAC ID: 9931010600
Enrollment ID: O20040413000541

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Robert Joseph Derveloy Iii is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Robert Joseph Derveloy Iii, MD
Po Box 7062,
Tupelo, MS 38802-7062

Ph: (662) 377-7170		Robert Joseph Derveloy Iii, MD
830 S Gloster St, Nmmc East Tower 4th Floor,
Tupelo, MS 38801-4934

Ph: (662) 377-7170

Reviews and Comments


Thoracic Surgery (Cardiothoracic Vascular Surgery) Doctors in Tupelo, MS

Vishal Sachdev, M.D.
Thoracic Surgery (Cardiothoracic Vascular Surgery)
Medicare: Accepting Medicare Assignments
Practice Location: 830 S Gloster St, Nmmc East Tower 4th Floor, Tupelo, MS 38801
Phone: 662-377-7170    Fax: 662-377-2423
Henry Patelford Ewing, M.D.
Thoracic Surgery (Cardiothoracic Vascular Surgery)
Medicare: Medicare Enrolled
Practice Location: 830 S Gloster St, Nmmc East Tower 4th Floor, Tupelo, MS 38801
Phone: 662-377-7170    Fax: 662-377-2423
David Smith Talton, M.D.
Thoracic Surgery (Cardiothoracic Vascular Surgery)
Medicare: Accepting Medicare Assignments
Practice Location: 830 S Gloster St, Nmmc East Tower 4th Floor, Tupelo, MS 38801
Phone: 662-377-7170    Fax: 662-377-2423
Dakota King, MD
Thoracic Surgery (Cardiothoracic Vascular Surgery)
Medicare: Not Enrolled in Medicare
Practice Location: 830 S Gloster St, Tupelo, MS 38801
Phone: 662-377-7170    Fax: 662-377-7180

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.