Individual provider Active NPI

Marcus Otavio Guimaraes Debiasi, CRNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Birmingham, AL
National Provider Identifier
1437601085
Registry record updated Jan 20, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
1-120823 Issued in AL
Practice address
1714 9TH Ave S Ste 300
Birmingham, AL 35205-3606
Phone
(205) 934-3580
NPI assigned
Oct 31, 2016
Last updated
Jan 20, 2017By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 1-120823 AL Primary

Addresses

Primary practice location

1714 9TH Ave S Ste 300
Birmingham, AL 35205-3606

Mailing address

PO Box 55310
Birmingham, AL 35255-5310
Phone (205) 731-9701

Other names 1

  • Marcus Otavio Guimaraes Debiasi Other name

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170221001046 AL Practitioner - Nurse Practitioner 2567746480 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1-120823ALMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
University of Alabama at Birmingham Current Accepting new patients
University of Alabama at Birmingham CurrentSince Jan 27, 2017 Accepting new patients
University of Alabama at Birmingham CurrentSince Jan 27, 2017 Accepting new patients

Locations

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

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1477872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1484870400000",
    "number": "1437601085",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 55310",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352555310",
            "telephone_number": "205-731-9701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1714 9TH AVE S STE 300",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352053606",
            "telephone_number": "205-934-3580"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEBIASI",
        "first_name": "MARCUS",
        "middle_name": "OTAVIO GUIMARAES",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-10-31",
        "last_updated": "2017-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "AL",
            "license": "1-120823",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARCUS",
            "last_name": "GUIMARAES DEBIASI",
            "middle_name": "OTAVIO",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Birmingham, AL

Sources for this page

Verify at the official NPI Registry.