Individual provider Active NPI

Nikhil Bush Jayaram

  • Gastroenterology Physician
  • Birmingham, AL
National Provider Identifier
1063130490
Registry record updated May 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
MD.50124 Issued in AL
Practice address
619 19TH St S
Birmingham, AL 35249-0020
Phone
(205) 934-4011
NPI assigned
Aug 22, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 20, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Gastroenterology Physician 207RG0100X MD.50124 AL Primary

Addresses

Primary practice location

619 19TH St S
Birmingham, AL 35249-0020

Mailing address

PO Box 55310
Birmingham, AL 35255-5310

Other practice location 1

1830 E Monument St # 406
Baltimore, MD 21287-0020
Phone (443) 248-6664

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address njayara3@jh.edu

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
I20250327003603 AL Practitioner - Internal Medicine 8325409113 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2000 6TH Ave S
Birmingham, AL 35233-2110
Phone (205) 937-9999

619 19TH St S
Birmingham, AL 35249-1900
Phone (205) 934-4011

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy110
Upper gastrointestinal (GI) endoscopy for acid reflux61

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
University of Alabama Health Services Foundation, PC. CurrentSince Feb 1, 2025 Accepting new patients
University of Alabama Health Services Foundation, PC CurrentSince Feb 1, 2025 Accepting new patients

Locations

619 19th St S
Birmingham, AL 35249

619 19th St S
Birmingham, AL 35233
Phone (205) 934-6405

Interoperability endpoints

  • Direct secure messaging: nbush2745949@direct.trinity-health.org

Organizations & group practices 2

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1661126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747699200000",
    "number": "1063130490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 55310",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352555310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "619 19TH ST S",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352490020",
            "telephone_number": "205-934-4011"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1830 E Monument St # 406",
            "address_purpose": "LOCATION",
            "city": "Baltimore",
            "state": "MD",
            "postal_code": "212870020",
            "country_code": "US",
            "telephone_number": "443-248-6664",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JAYARAM",
        "first_name": "NIKHIL BUSH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-08-22",
        "last_updated": "2025-05-20",
        "certification_date": "2025-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "AL",
            "license": "MD.50124",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "njayara3@jh.edu",
            "affiliation": "N",
            "address_1": "1830 E Monument St # 406",
            "city": "Baltimore",
            "state": "MD",
            "country_code": "US",
            "postal_code": "212870020",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Birmingham, AL

Sources for this page

Verify at the official NPI Registry.