Individual provider Active NPI

Raphael T. Benaksas

  • Internal Medicine Physician
  • Birmingham, AL
National Provider Identifier
1154884930
Registry record updated Jul 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD.42182 Issued in AL
Practice address
3690 Grandview Pkwy
Birmingham, AL 35243-3326
Phone
(205) 971-5745
NPI assigned
Apr 9, 2019
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD.42182 AL Primary

Addresses

Primary practice location

3690 Grandview Pkwy
Birmingham, AL 35243-3326

Mailing address

3690 Grandview Pkwy
Birmingham, AL 35243-3326
Phone (205) 971-5745

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220822002224 AL Practitioner - Hospitalist 5698158707 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Hospitalist
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hospital Physician Services - Southeast Professional Corporation 825 clinicians

Practice addresses (Care Compare)

1000 1St St N
Alabaster, AL 35007-8703
Phone (205) 620-8100

Hospital & facility affiliations

  • Shelby Baptist Medical Center Hospital, Alabaster, AL, CCN 010016

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD.42182ALMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hospital Physician Services - Southeast Professional Corporation CurrentSince Jul 1, 2022 Accepting new patients
BBH SBMC, LLC Past Accepting new patients

Locations

1000 1st St N
Alabaster, AL 35007
Phone (205) 620-8100

124 S Memorial Dr
Prattville, AL 36067
Phone (334) 361-4267

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 1

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": "1554768000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657238400000",
    "number": "1154884930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3690 GRANDVIEW PKWY",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352433326",
            "telephone_number": "205-971-5745"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3690 GRANDVIEW PKWY",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352433326",
            "telephone_number": "205-971-5745"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENAKSAS",
        "first_name": "RAPHAEL",
        "middle_name": "T.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-04-09",
        "last_updated": "2022-07-08",
        "certification_date": "2022-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AL",
            "license": "MD.42182",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Birmingham, AL

Sources for this page

Verify at the official NPI Registry.