NPIMap

Organization Active NPI

Plastic Surgery of Tuscaloosa Inc

  • Plastic and Reconstructive Surgery Physician
  • Tuscaloosa, AL
National Provider Identifier
1316014681
Registry record updated Oct 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic and Reconstructive Surgery PhysicianTaxonomy code 2086S0122X
Legal business name
PLASTIC SURGERY OF TUSCALOOSA INC
Practice address
1847 Commons North Dr Ste a
Tuscaloosa, AL 35406-3700
Phone
(205) 349-0049
Fax
(659) 734-2003
NPI assigned
Nov 29, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2023

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

Authorized official

Name
Marquis Hester
Title
Insurance
Phone
(205) 349-0049

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic and Reconstructive Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2086S0122X Primary

Addresses

Primary practice location

1847 Commons North Dr Ste a
Tuscaloosa, AL 35406-3700

Mailing address

1847 Commons North Dr Ste a
Tuscaloosa, AL 35406-3700
Phone (205) 349-0049

Other identifiers 1

IdentifierTypeStateIssuer
529900080MedicaidAL

Other names 1

  • NA Former legal business name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20051115000586 AL Part B Supplier - Clinic/Group Practice 0244259638 Receives reassigned benefits from 3 practitioners
Practice locations: Tuscaloosa, AL

National Provider Directory

National Provider Directory

Locations

1847 Commons North Dr
Ste A
Tuscaloosa, AL 35406
Phone (205) 345-6272

1814 CMNS N Dr
Tuscaloosa, AL 35406

701 University Blvd E
Ste 804
Tuscaloosa, AL 35401
Phone (205) 391-9038

701 University Blvd E
Ste 902
Tuscaloosa, AL 35401
Phone (205) 391-9038

Practitioners & affiliated clinicians

Practitioners 6

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": "1164758400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1696291200000",
    "number": "1316014681",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1847 COMMONS NORTH DR STE A",
            "city": "TUSCALOOSA",
            "state": "AL",
            "postal_code": "354063700",
            "telephone_number": "205-349-0049",
            "fax_number": "659-734-2003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1847 COMMONS NORTH DR STE A",
            "city": "TUSCALOOSA",
            "state": "AL",
            "postal_code": "354063700",
            "telephone_number": "205-349-0049",
            "fax_number": "659-734-2003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PLASTIC SURGERY OF TUSCALOOSA INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-29",
        "last_updated": "2023-10-03",
        "certification_date": "2023-10-03",
        "status": "A",
        "authorized_official_last_name": "HESTER",
        "authorized_official_first_name": "MARQUIS",
        "authorized_official_title_or_position": "INSURANCE",
        "authorized_official_telephone_number": "205-349-0049"
    },
    "taxonomies": [
        {
            "code": "2086S0122X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "529900080",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "NA",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "NA",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Tuscaloosa, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2023; 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.