Individual provider Active NPI

Nicholas Jeremy Cajacob, M.D.

  • Pediatric Gastroenterology Physician
  • Birmingham, AL
National Provider Identifier
1346568664
Registry record updated Jun 12, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Gastroenterology PhysicianTaxonomy code 2080P0206X
License
MD.31444 Issued in AL
Practice address
1600 7TH Ave South McWane 5604
Birmingham, AL 35249-1900
Phone
(205) 638-9918
NPI assigned
May 11, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X MD.31444 AL
Pediatric Gastroenterology Physician 2080P0206X MD.31444 AL Primary

Addresses

Primary practice location

1600 7TH Ave South McWane 5604
Birmingham, AL 35249-1900

Mailing address

1600 7TH Ave South McWane 5604
Birmingham, AL 35249-1900
Phone (205) 638-9918

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
I20140423000129 AL Practitioner - Pediatric Medicine 1759527450 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
University of Cincinnati College of Medicine, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1600 7TH Ave S
Birmingham, AL 35233-1711
Phone (205) 975-9925

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD.31444ALMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Alabama Health Services Foundation, PC. CurrentSince Apr 1, 2014 Accepting new patients
University of Alabama Health Services Foundation, PC Pediatrics CurrentSince Apr 1, 2014 Accepting new patients
The Children'S Hospital of Alabama Past Accepting new patients

Locations

619 19th St S
Birmingham, AL 35249

703 Volker Hall
Birmingham, AL 35294
Phone (205) 638-9587

1600 7th Ave S
#5604
Birmingham, AL 35233
Phone (205) 638-9918

1600 7th Ave S
Birmingham, AL 35233
Phone (205) 638-9100

Interoperability endpoints

  • Direct secure messaging: ncajacob18609@childrensofalabama.direct-ci.com
  • Direct secure messaging: ncajacob@direct.uabmedicine.org

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.

NPI Registry JSON

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

{
    "created_epoch": "1273536000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591920000000",
    "number": "1346568664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 7TH AVE SOUTH MCWANE 5604",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352491900",
            "telephone_number": "205-638-9918"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 7TH AVE SOUTH MCWANE 5604",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352491900",
            "telephone_number": "205-638-9918"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAJACOB",
        "first_name": "NICHOLAS",
        "middle_name": "JEREMY",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-05-11",
        "last_updated": "2020-06-12",
        "certification_date": "2020-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "AL",
            "license": "MD.31444",
            "primary": false
        },
        {
            "code": "2080P0206X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Gastroenterology",
            "state": "AL",
            "license": "MD.31444",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Birmingham, AL

Sources for this page

Verify at the official NPI Registry.