Individual provider Active NPI

Stephen L Avram, MD

  • Internal Medicine Physician
  • Oneonta, AL
National Provider Identifier
1174519623
Registry record updated Jun 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
013125 Issued in AL
Practice address
2040 2ND Ave E
Suite a
Oneonta, AL 35121-2731
Phone
(205) 274-9700
Fax
(205) 274-9714
NPI assigned
Sep 21, 2005
Last updated
Jun 20, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2024

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 013125 AL Primary

Addresses

Primary practice location

2040 2ND Ave E
Suite a
Oneonta, AL 35121-2731

Mailing address

2040 2ND Ave E
Suite a
Oneonta, AL 35121-2731
Phone (205) 274-9700

Other identifiers 5

IdentifierTypeStateIssuer
051545771OtherALBCBS
051554535MedicaidAL
051521662OtherALBCBS
009914076MedicaidAL
4046941OtherALAETNA

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
I20040312000386 AL Practitioner - Internal Medicine 5890684344 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

200 2ND Ave E
Oneonta, AL 35121-1716
Phone (256) 878-1415

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
013125ALMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St. Vincent's Blount Past Accepting new patients
Eastside Ventures, Inc. Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/EGCBCA/Endpoint/EGCBCA

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

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": "1127260800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718841600000",
    "number": "1174519623",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2040 2ND AVE E",
            "address_2": "SUITE A",
            "city": "ONEONTA",
            "state": "AL",
            "postal_code": "351212731",
            "telephone_number": "205-274-9700",
            "fax_number": "205-274-9714"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2040 2ND AVE E",
            "address_2": "SUITE A",
            "city": "ONEONTA",
            "state": "AL",
            "postal_code": "351212731",
            "telephone_number": "205-274-9700",
            "fax_number": "205-274-9714"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AVRAM",
        "first_name": "STEPHEN",
        "middle_name": "L",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-21",
        "last_updated": "2024-06-20",
        "certification_date": "2024-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AL",
            "license": "013125",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "051545771",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "051554535",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "051521662",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009914076",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "4046941",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oneonta, AL

Sources for this page

Verify at the official NPI Registry.