Individual provider Active NPI

Mollie Rene Deshazo, MD

  • Hematology & Oncology Physician
  • Birmingham, AL
National Provider Identifier
1487603841
Registry record updated Oct 20, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
24415 Issued in AL
Practice address
619 19TH Street South
Birmingham, AL 35233
Phone
(205) 934-6600
NPI assigned
May 10, 2006
Last updated
Oct 20, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology Physician 207RH0003X 24415 AL Primary

Addresses

Primary practice location

619 19TH Street South
Birmingham, AL 35233

Mailing address

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

Other identifiers 7

IdentifierTypeStateIssuer
009936801MedicaidAL
009936802MedicaidAL
P00376923OtherALRAILROAD MEDICARE
051534114OtherALBCBS
051534115OtherALBCBS
051534116OtherALBCBS
009936803MedicaidAL

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
I20060628000334 AL Practitioner - Hematology/Oncology 8123030558 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Hematology/Oncology
Education
University of Alabama School of Medicine, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

2000 6TH Ave S
Birmingham, AL 35233-2110
Phone (205) 937-9999

619 19TH St S
Birmingham, AL 35249-1900
Phone (205) 934-4011

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
83.04 of 100Reported as group
Quality
68.83
Promoting interoperability
89
Improvement activities
40
Cost
83.82

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
24415ALMDHematology & Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Alabama Health Services Foundation, PC. CurrentSince Jul 1, 2006 Accepting new patients
Urology Centers of Alabama PC CurrentSince Dec 20, 2021 Accepting new patients
Urology Centers of Alabama PC CurrentSince Dec 20, 2021 Accepting new patients

Locations

619 19th St S
Birmingham, AL 35249

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

500 22nd St S
Birmingham, AL 35233
Phone (205) 801-7440

2145 Bonner Way
Birmingham, AL 35243
Phone (205) 978-0250

3485 Independence Dr
Homewood, AL 35209

Interoperability endpoints

  • Direct secure messaging: molliedeshazo@uca.allscriptsdirect.net

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.

Hospital & facility affiliations 2

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": "1147219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1319068800000",
    "number": "1487603841",
    "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": "619 19TH STREET SOUTH",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "35233",
            "telephone_number": "205-934-6600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DESHAZO",
        "first_name": "MOLLIE",
        "middle_name": "RENE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-10",
        "last_updated": "2011-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "AL",
            "license": "24415",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009936801",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009936802",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00376923",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "051534114",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "051534115",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "051534116",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009936803",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Birmingham, AL

Sources for this page

Verify at the official NPI Registry.