NPIMap

Individual provider Active NPI

Pavan Kiran Madadi

  • Internal Medicine Physician
  • Montgomery, AL
National Provider Identifier
1306178496
Registry record updated Feb 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
30392 Issued in AL
Practice address
1725 Pine St
Jackson Hospital
Montgomery, AL 36106-1109
Phone
(334) 293-8067
Fax
(954) 367-8512
NPI assigned
Feb 1, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 25, 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 30392 AL Primary

Addresses

Primary practice location

1725 Pine St
Jackson Hospital
Montgomery, AL 36106-1109

Mailing address

1725 Pine St
Jackson Hospital
Montgomery, AL 36106-1109
Phone (334) 293-8067

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101101000146 AL Practitioner - Internal Medicine 6103010483 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Jackson Hospital and Clinic, Inc 119 clinicians
Hospital Physician Services - Southeast Professional Corporation 825 clinicians

Practice addresses (Care Compare)

1722 Pine St
Montgomery, AL 36106-1109

1722 Pine St
Montgomery, AL 36106-1160

1725 Pine St
Montgomery, AL 36106-1109
Phone (334) 293-8000

701 Princeton Ave SW
Birmingham, AL 35211-1303
Phone (205) 783-3000

Hospital & facility affiliations

  • Princeton Baptist Medical Center Hospital, Birmingham, AL, CCN 010103
  • Walker Baptist Medical Center Hospital, Jasper, AL, CCN 010089
  • Shelby Baptist Medical Center Hospital, Alabaster, AL, CCN 010016
  • Jackson Hospital & Clinic Inc Hospital, Montgomery, AL, CCN 010024

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Jackson Hospital & Clinic, Inc. CurrentSince Aug 1, 2015 Accepting new patients
Crestwood HB Medical Services LLC CurrentSince Feb 16, 2024 Accepting new patients
Hospital Physician Services - Southeast Professional Corporation CurrentSince Feb 1, 2025 Accepting new patients
Jackson Hospital and Clinic, Inc. Internal Medicine Current Accepting new patients
Jackson Hospital and Clinic, Inc. CurrentSince Aug 1, 2015 Accepting new patients
BBH PBMC, LLC Past Accepting new patients
Jackson Hospital & Clinic, Inc. Past Accepting new patients
Apogee Medical Group Alabama Inc Internal Medicine Past Accepting new patients

Locations

701 Princeton Ave SW
Birmingham, AL 35211
Phone (205) 279-2860

1 Hospital Dr SW
Huntsville, AL 35801
Phone (256) 429-4000

1725 Pine St
Montgomery, AL 36106
Phone (334) 293-8000

1758 Park Pl
Ste 300
Montgomery, AL 36106
Phone (334) 274-1204

1722 Pine St
Ste 503
Montgomery, AL 36106
Phone (334) 240-2337

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

604 Stone Ave
Talladega, AL 35160
Phone (256) 362-8111

Interoperability endpoints

  • Direct secure messaging: pavan.madadi.1@9186.direct.athenahealth.com

Organizations & group practices 11

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": "1264982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708819200000",
    "number": "1306178496",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1725 PINE ST",
            "address_2": "JACKSON HOSPITAL",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361061109",
            "telephone_number": "334-293-8067",
            "fax_number": "954-367-8512"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1725 PINE ST",
            "address_2": "JACKSON HOSPITAL",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361061109",
            "telephone_number": "334-293-8067",
            "fax_number": "954-367-8512"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MADADI",
        "first_name": "PAVAN",
        "middle_name": "KIRAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-02-01",
        "last_updated": "2024-02-25",
        "certification_date": "2024-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AL",
            "license": "30392",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Montgomery, AL

Sources for this page

Verify at the official NPI Registry.