Individual provider Active NPI

Alan Pernick, MD

  • Family Medicine Physician
  • Tuscaloosa, AL
National Provider Identifier
1578664215
Registry record updated Jan 7, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
L-2631 Issued in AL
Practice address
850 5TH Ave E
Tuscaloosa, AL 35401-7419
Phone
(205) 348-1770
Fax
(205) 348-7216
NPI assigned
Sep 26, 2006
Last updated
Jan 7, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X L-2631 AL Primary

Addresses

Primary practice location

850 5TH Ave E
Tuscaloosa, AL 35401-7419

Mailing address

PO Box 2153
Dept 5075
Birmingham, AL 35287-0002

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
I20080318000052 AL Practitioner - Family Practice 4688759566 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Doctors Med Care of Gadsden, P.C.Group PAC ID 7517870389, 9 clinicians

Practice addresses (Care Compare)

3206 W Meighan Blvd
Gadsden, AL 35904-1726
Phone (256) 547-2153

3206 W Meighan Blvd
Gadsden, AL 35904-1732
Phone (256) 547-2153

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
L-2631ALMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Doctors Med Care of Gadsden, P.C. Family Medicine CurrentSince Oct 3, 2008 Accepting new patients
Alabama Hma Physician Management, LLC Family Medicine Past Accepting new patients
Neal D.Van Marter Family Medicine Past Accepting new patients

Locations

2108 Rainbow Dr
Gadsden, AL 35901
Phone (256) 547-0160

3206 W Meighan Blvd
Gadsden, AL 35904
Phone (256) 547-2153

Interoperability endpoints

  • Direct secure messaging: alan.pernick@docmedgad.direct.medconnect-inc.com

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": "1159228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1357516800000",
    "number": "1578664215",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2153",
            "address_2": "DEPT 5075",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352870002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "850 5TH AVE E",
            "city": "TUSCALOOSA",
            "state": "AL",
            "postal_code": "354017419",
            "telephone_number": "205-348-1770",
            "fax_number": "205-348-7216"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERNICK",
        "first_name": "ALAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-26",
        "last_updated": "2013-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AL",
            "license": "L-2631",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tuscaloosa, AL

Sources for this page

Verify at the official NPI Registry.