NPIMap

Organization Active NPI

Eastern Surgical Associates, P.C.

  • Specialist
  • Birmingham, AL
National Provider Identifier
1265589972
Registry record updated Feb 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
EASTERN SURGICAL ASSOCIATES, P.C.
Practice address
52 Medical Park East Drive
Suite 308
Birmingham, AL 35235-3433
Phone
(208) 838-3025
Fax
(205) 838-3897
NPI assigned
Jan 4, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2022

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

Authorized official

Name
Robin M Smith
Title
Practice Manager
Phone
(205) 838-3025

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X Primary

Addresses

Primary practice location

52 Medical Park East Drive
Suite 308
Birmingham, AL 35235-3433

Mailing address

52 Medical Park East Drive
Suite 308
Birmingham, AL 35235-3433
Phone (205) 838-3025

Other names 1

  • Lytle Perry Heinzman Wood, P.C. Former legal business name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060105000685 AL Part B Supplier - Clinic/Group Practice 9537182407 Receives reassigned benefits from 7 practitioners
Practice locations: Birmingham, AL; Oneonta, AL; Pell City, AL

National Provider Directory

National Provider Directory

Locations

52 Medical Park Dr E
Ste 308
Birmingham, AL 35235
Phone (205) 838-3025

2700 10th Ave S
Ste 402
Birmingham, AL 35205
Phone (205) 933-0439

Interoperability endpoints

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

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1167868800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1645142400000",
    "number": "1265589972",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "52 MEDICAL PARK EAST DRIVE",
            "address_2": "SUITE 308",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352353433",
            "telephone_number": "205-838-3025",
            "fax_number": "205-838-3897"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "52 MEDICAL PARK EAST DRIVE",
            "address_2": "SUITE 308",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352353433",
            "telephone_number": "208-838-3025",
            "fax_number": "205-838-3897"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EASTERN SURGICAL ASSOCIATES, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-04",
        "last_updated": "2022-02-18",
        "certification_date": "2022-02-18",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "ROBIN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "205-838-3025"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lytle Perry Heinzman Wood, P.C.",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "Lytle Perry Heinzman Wood, P.C.",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Birmingham, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.