Individual provider Active NPI

Panayiotis P Grevenitis, M.D.

  • Gastroenterology Physician
  • Mobile, AL
National Provider Identifier
1073834792
Registry record updated Oct 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
MD.35145 Issued in AL
Practice address
3601 Springhill Business Park Ste 201
Mobile, AL 36608-1263
Phone
(251) 873-6192
NPI assigned
Jun 16, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 2, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X LL32661 SC
Gastroenterology Physician 207RG0100X MD.35145 AL Primary

Addresses

Primary practice location

3601 Springhill Business Park Ste 201
Mobile, AL 36608-1263

Mailing address

480 Honeysuckle Rd
Dothan, AL 36305-1156
Phone (334) 836-1212

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
I20160719000754 AL Practitioner - GastroenterologyPractitioner - Internal Medicine 2769603661 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
GastroenterologyAlso: Internal Medicine
Education
University of South Alabama College of Medicine, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Gut PCGroup PAC ID 3375589799, 53 clinicians

Practice addresses (Care Compare)

3601 Spring Hill Business Park
Suite 201
Mobile, AL 36608
Phone (251) 873-6192

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy204
Upper gastrointestinal (GI) endoscopy for acid reflux139

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
LL32661SCMDInternal Medicine Physician
MD.35145ALMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Internal Medicine Center LLC Current Accepting new patients
Gut PC Gastroenterology Current Accepting new patients
Gut PC CurrentSince Mar 15, 2021 Accepting new patients

Locations

480 Honeysuckle Rd
Dothan, AL 36305
Phone (334) 792-6933

3601 Springhill Business Park
Ste 201
Mobile, AL 36608
Phone (251) 873-6192

Interoperability endpoints

  • Direct secure messaging: panayiotisgrevenitis@amgmd.allscriptsdirect.net

Organizations & group practices 3

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": "1276646400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696204800000",
    "number": "1073834792",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "480 HONEYSUCKLE RD",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363051156",
            "telephone_number": "334-836-1212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3601 SPRINGHILL BUSINESS PARK STE 201",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366081263",
            "telephone_number": "251-873-6192"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREVENITIS",
        "first_name": "PANAYIOTIS",
        "middle_name": "P",
        "name_prefix": "Mr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-06-16",
        "last_updated": "2023-10-02",
        "certification_date": "2023-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "SC",
            "license": "LL32661",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "AL",
            "license": "MD.35145",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mobile, AL

Sources for this page

Verify at the official NPI Registry.