Bindu Bennuri, MD
Individual provider Active NPI Allergy & Immunology (Internal Medicine) Physician · Northport, AL
NPI 1063511202 · NPPES record last updated Mar 14, 2023
Key facts
- NPI
- 1063511202
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Allergy & Immunology (Internal Medicine) Physician 207RA0201X
- License
- 22399 (AL)
- Practice address
- 2701 20TH Avenue
Northport, AL 35476-3832 - Phone
- (205) 333-5900
- Fax
- (205) 333-6090
- NPI assigned
- Sep 22, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare Care Compare profile
- Specialty
- Allergy/Immunology
- Education
- Other, 1990
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
920 Rose Dr
Northport, AL 35476-3363
Phone (205) 339-5900
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in AL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20040309000566 | AL | Practitioner - Allergy/Immunology |
6901794171 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 22399 | AL | MD | Allergy & Immunology (Internal Medicine) Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bama Pedicatrics LLC | Current |
Accepting new patients | |
| Military Spousal Support Center | Current | Accepting new patients |
Locations
920 Rose Dr
Northport, AL 35476
Phone (205) 333-5900
Interoperability endpoints
- bindu.bennuri@bamapeds.directbygreenway.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Allergy & Immunology (Internal Medicine) Physician | 207RA0201X | 22399 | AL | Yes |
Addresses
Primary practice location
2701 20TH Avenue
Northport, AL 35476-3832
Mailing address
2701 20TH Avenue
Northport, AL 35476-3832
Phone (205) 333-5900
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 009978015 | Medicaid | AL |
Other providers in Northport, AL
- Anna Beatty
- Cheryl Sue Beaube-Hines
- Katharine Foster Bedsole
- Bennett Speech Therapy
- April F Bennett
- Sudha Sagar Bennuri
- India Jeaneice Berryhill
- Erica Monique Bettis
- Rose M Betz
- Justin Ray Bevel
All providers in Northport, AL · Allergy & Immunology (Internal Medicine) Physician in Alabama
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 14, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.