Individual provider Active NPI

Naga Raju Danthuluri, MD

  • Anesthesiology Physician
  • Decatur, AL
National Provider Identifier
1396862629
Registry record updated Nov 5, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
00020090 Issued in AL
Practice address
2828 Highway 31 S
Decatur, AL 35603-1510
Phone
(256) 340-1212
NPI assigned
Mar 23, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 5, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 00020090 AL Primary

Addresses

Primary practice location

2828 Highway 31 S
Decatur, AL 35603-1510

Mailing address

2828 Highway 31 S
Decatur, AL 35603-1510
Phone (256) 340-1212

Other identifiers 1

IdentifierTypeStateIssuer
000021165MedicaidAL

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
I20111202000556 AL Practitioner - Anesthesiology 4486829439 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
University of South Alabama College of Medicine, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Decatur Surgery Center LPGroup PAC ID 5698798346, 2 clinicians

Practice addresses (Care Compare)

2828 Hwy 31 S
Decatur, AL 35603-1538
Phone (256) 340-1212

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
00020090ALMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Decatur Surgery Center LP CurrentSince Jun 28, 1999 Accepting new patients
Decatur Ambulatory Surgery Center Anesthesiology CurrentSince Jun 28, 1999 Accepting new patients

Locations

2828 Highway 31 S
Decatur, AL 35603
Phone (256) 340-1212

Organizations & group practices 2

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": "1174608000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1446681600000",
    "number": "1396862629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2828 HIGHWAY 31 S",
            "city": "DECATUR",
            "state": "AL",
            "postal_code": "356031510",
            "telephone_number": "256-340-1212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2828 HIGHWAY 31 S",
            "city": "DECATUR",
            "state": "AL",
            "postal_code": "356031510",
            "telephone_number": "256-340-1212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DANTHULURI",
        "first_name": "NAGA",
        "middle_name": "RAJU",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-23",
        "last_updated": "2015-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "AL",
            "license": "00020090",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000021165",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Decatur, AL

Sources for this page

Verify at the official NPI Registry.