Individual provider Active NPI

Mamatha Gandhi, MBBS

  • Nephrology Physician
  • Birmingham, AL
National Provider Identifier
1154587897
Registry record updated Aug 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
30960 Issued in AL
Practice address
619 19TH St S
Birmingham, AL 35233-1900
Phone
(205) 934-4011
NPI assigned
Aug 1, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 7, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X 30960 AL Primary

Addresses

Primary practice location

619 19TH St S
Birmingham, AL 35233-1900

Mailing address

PO Box 55310
Birmingham, AL 35255-5310

Other practice location 1

3570 Grandview Pkwy Ste 101
Birmingham, AL 35243-2065
Phone (205) 354-2100

Other identifiers 1

IdentifierTypeStateIssuer
171183MedicaidAL

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
I20110715000355 AL Practitioner - Internal MedicinePractitioner - Nephrology 1052589165 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Nephrology
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
University of Alabama Health Services Foundation, PCGroup PAC ID 1951213107, 2,784 clinicians

Practice addresses (Care Compare)

619 19TH St S
Birmingham, AL 35246-0001
Phone (205) 934-3460

Hospital & facility affiliations

  • DaVita Imperial Home Dialysis Dialysis facility, Birmingham, AL, CCN 012716
  • University of Alabama Hospital Hospital, Birmingham, AL, CCN 010033

Merit-based Incentive Payment System (MIPS)

Final score
19.37 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
64.58

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
30960ALMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southern Kidney Care PC Nephrology CurrentSince Mar 1, 2021 Accepting new patients
University of Alabama Health Services Foundation, PC. CurrentSince Aug 1, 2024 Accepting new patients
Nephrology Medical Associates of Georgia LLC Nephrology CurrentSince Sep 1, 2013 Accepting new patients
Oak Mountain Group Services, LLC CurrentSince Apr 1, 2024 Accepting new patients
Nephrology Medical Associates of Georgia, LLC Nephrology CurrentSince Sep 1, 2013 Accepting new patients
Oak Mountain Group Services, LLC CurrentSince Apr 1, 2024 Accepting new patients
Chitto Dialysis LLC PastSince Apr 8, 2020 Accepting new patients
Gadsden Nephrology LLC Nephrology Past Accepting new patients

Locations

619 19th St S
Birmingham, AL 35249

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

3570 Grandview Pkwy
Ste 101
Birmingham, AL 35243
Phone (205) 354-2100

1201 11th Ave S
Birmingham, AL 35205
Phone (205) 930-7100

339 Walker Chapel Plz
Ste 115
Fultondale, AL 35068
Phone (205) 250-6424

300 Medical Center Dr
Ste 102
Gadsden, AL 35903
Phone (256) 492-7965

3690 Grandview Pkwy
Vestavia, AL 35243
Phone (205) 592-1000

3070 Healthy Way
Vestavia, AL 35243
Phone (205) 977-7216

1840 E Ray Rd
Chandler, AZ 85225
Phone (855) 397-0197

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/14272/brand/70/csg/1/fhir/r4

Organizations & group practices 8

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": "1217548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722988800000",
    "number": "1154587897",
    "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": "352331900",
            "telephone_number": "205-934-4011"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3570 Grandview Pkwy Ste 101",
            "address_purpose": "LOCATION",
            "city": "Birmingham",
            "state": "AL",
            "postal_code": "352432065",
            "country_code": "US",
            "telephone_number": "205-354-2100",
            "fax_number": "866-343-6766",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GANDHI",
        "first_name": "MAMATHA",
        "name_prefix": "Dr.",
        "credential": "MBBS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-08-01",
        "last_updated": "2024-08-07",
        "certification_date": "2024-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "AL",
            "license": "30960",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "171183",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Birmingham, AL

Sources for this page

Verify at the official NPI Registry.