Elise Debruler Agostinelli, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

S-E53-TA-B84 Issued in AL

Practice address

1720 University Blvd
Birmingham, AL 35233-1816

Phone

(205) 488-0736

NPI assigned

Aug 10, 2020

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Elise Debruler Former name

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in AL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

University of Alabama at BirminghamGroup PAC ID 3779487970, 93 clinicians

University of Alabama Ophthalmology Services FoundationGroup PAC ID 9234023417, 23 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

84.74 of 100Reported as group

Quality

79.85

Promoting interoperability

98

Improvement activities

40

Cost

70.94

Medicare enrollment (NPD)

Enrolled

Practice roles (7 of 10)

Locations

Networks

• MS PPO D-SNP
• MS PPO
• MS PPO C-SNP

Interoperability endpoints

• Direct secure messaging: edebruler@direct.uabmedicine.org
• Direct secure messaging: elise.debruler.d1.p1@direct.uabmc.nextgenshare.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• University of Alabama at Birmingham

  • Internal Medicine Physician
  • Montgomery, AL
  • NPI 1184738478
  Medicare reassignment Care Compare group NPD
• University of Alabama Ophthalmology Services Foundation

  • Ophthalmology Physician
  • Birmingham, AL
  • NPI 1265485999
  Medicare reassignment Care Compare group NPD
• University of Alabama Health Services Foundation, PC.

  • Multi-Specialty Clinic/Center
  • Birmingham, AL
  • NPI 1093768723
  Medicare reassignment NPD
• University of Alabama at Birmingham

  • General Acute Care Hospital
  • Birmingham, AL
  • NPI 1407995186
  NPD
• University of Alabama at Birmingham

  • General Acute Care Hospital
  • Birmingham, AL
  • NPI 1447145818
  NPD
• Uab Callahan Eye Hospital Authority

  • Ophthalmology Physician
  • Birmingham, AL
  • NPI 1427398254
  NPD (past)
• University of Alabama at Birmingham

  • Emergency Medicine Physician
  • Birmingham, AL
  • NPI 1407837750
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1597017600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624838400000",
    "number": "1013528579",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1720 UNIVERSITY BLVD",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352331816"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1720 UNIVERSITY BLVD",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352331816",
            "telephone_number": "205-488-0736"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AGOSTINELLI",
        "first_name": "ELISE",
        "middle_name": "DEBRULER",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-08-10",
        "last_updated": "2021-06-28",
        "certification_date": "2021-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AL",
            "license": "S-E53-TA-B84",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "S-E53-TA-B84",
            "state": "AL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "edebruler@uabmc.edu",
            "affiliation": "N",
            "endpointDescription": "email",
            "address_1": "1720 University Blvd",
            "city": "Birmingham",
            "state": "AL",
            "country_code": "US",
            "postal_code": "352331816",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "ELISE",
            "last_name": "DEBRULER",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Agilitas USA, Inc
• Agilitas USA, Inc
• Aging With Care Home Health LLC
• Shruti Agnihotri
• Rosebella Adhiambo Agola, M.D.
• Paul Agostini, M.A.
• Pooja Agrawal, MD
• Brandon Agsalud
• Agsauv Podiatry & Mobility Solutions
• Leslie Elizabeth Aguero

• Optometrist in Birmingham, AL
• Providers in Birmingham, AL by specialty
• Optometrist in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.