Individual provider Active NPI

Melissa Jane Puntkattalee

  • Family Medicine Physician
  • Birmingham, AL
National Provider Identifier
1033679972
Registry record updated Feb 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD.48133 Issued in AL
Practice address
5720 1St Ave S
Birmingham, AL 35212-2522
Phone
(205) 380-9455
Fax
(205) 380-9459
NPI assigned
Mar 25, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD.48133 AL Primary

Addresses

Primary practice location

5720 1St Ave S
Birmingham, AL 35212-2522

Mailing address

5720 1St Ave S
Birmingham, AL 35212-2522
Phone (205) 380-9455

Medicare participation

Medicare enrollment files
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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240306000644 AL Practitioner - Family PracticePractitioner - Obstetrics/Gynecology 7618313230 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Obstetrics/Gynecology
Education
Medical College of Georgia School of Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Christ Health Center IncGroup PAC ID 9931106986, 22 clinicians

Practice addresses (Care Compare)

5720 1St Ave S
Birmingham, AL 35212-2522
Phone (205) 380-9455

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD.48133ALMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Christ Health Center Inc Family Medicine CurrentSince Mar 4, 2024 Accepting new patients
Christ Health Center Inc CurrentSince Mar 4, 2024 Accepting new patients
St. Vincent'S Birmingham Past Accepting new patients
St. Vincent'S East Past Accepting new patients

Locations

5720 1st Ave S
Birmingham, AL 35212
Phone (205) 380-9455

2152 Old Springville Rd
Center Point, AL 35215
Phone (205) 838-6000

Interoperability endpoints

  • Direct secure messaging: jane.puntkattalee.1@12373.direct.athenahealth.com

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1553472000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707091200000",
    "number": "1033679972",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5720 1ST AVE S",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352122522",
            "telephone_number": "205-380-9455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5720 1ST AVE S",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352122522",
            "telephone_number": "205-380-9455",
            "fax_number": "205-380-9459"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PUNTKATTALEE",
        "first_name": "MELISSA",
        "middle_name": "JANE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-25",
        "last_updated": "2024-02-05",
        "certification_date": "2024-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AL",
            "license": "MD.48133",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Birmingham, AL

Sources for this page

Verify at the official NPI Registry.