Individual provider Active NPI

Sandhya Narukonda

  • Geriatric Medicine (Internal Medicine) Physician
  • Birmingham, AL
National Provider Identifier
1265838445
Registry record updated Dec 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X
License
36171 Issued in AL
Practice address
1201 11TH Ave S
Birmingham, AL 35205-3423
Phone
(205) 930-7100
NPI assigned
Nov 14, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Internal Medicine) Physician 207RG0300X 36171 AL Primary

Addresses

Primary practice location

1201 11TH Ave S
Birmingham, AL 35205-3423

Mailing address

1201 11TH Ave S
Birmingham, AL 35205-3423

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL, FL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20181002000386 AL Practitioner - Geriatric MedicinePractitioner - Internal Medicine 0547576795 Reassigns benefits to 1 organization
I20211022001799 FL Practitioner - Internal Medicine 0547576795 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dedicated Senior Medical Center of Florida, LLCGroup PAC ID 4486932100, 56 clinicians

Practice addresses (Care Compare)

3059 Edgewood Ave W
Jacksonville, FL 32209-2207
Phone (904) 647-3180

Hospital & facility affiliations

  • Vitas Healthcare Corporation of Florida Hospice, Melbourne, FL, CCN 101545

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
36171ALMDGeriatric Medicine (Internal Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dedicated Senior Medical Center of Florida, LLC CurrentSince Nov 1, 2021 Accepting new patients
University of Alabama Health Services Foundation, PC. CurrentSince Jul 1, 2018 Accepting new patients
Dedicated Senior Medical Center of Florida, LLC CurrentSince Nov 1, 2021 Accepting new patients

Locations

619 19th St S
Birmingham, AL 35249

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

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

3059 Edgewood Ave W
Jacksonville, FL 32209
Phone (904) 647-3180

8000 Lem Turner Rd
#2
Jacksonville, FL 32208
Phone (904) 539-8200

4715 S Florida Ave
Lakeland, FL 33813
Phone (863) 209-7003

1395 NW 167th St
Miami Gardens, FL 33169
Phone (305) 831-4760

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

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 4

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": "1415923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671148800000",
    "number": "1265838445",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1201 11TH AVE S",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352053423"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 11TH AVE S",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352053423",
            "telephone_number": "205-930-7100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NARUKONDA",
        "first_name": "SANDHYA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-11-14",
        "last_updated": "2022-12-16",
        "certification_date": "2021-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "AL",
            "license": "36171",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Birmingham, AL

Sources for this page

Verify at the official NPI Registry.