NPIMap

Individual provider Active NPI

Sumeet Munjal, MD

  • Nephrology Physician
  • Montgomery, AL
National Provider Identifier
1578819546
Registry record updated Nov 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
MD.35005 Issued in AL
Practice address
239 Mitylene Park Dr
Montgomery, AL 36117-3547
Phone
(334) 603-6626
Fax
(706) 324-3419
NPI assigned
Jul 27, 2012
Last updated
Nov 13, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Nephrology Physician 207RN0300X MD.35005 AL Primary

Addresses

Primary practice location

239 Mitylene Park Dr
Montgomery, AL 36117-3547

Mailing address

239 Mitylene Park Dr
Montgomery, AL 36117-3547
Phone (706) 322-1486

Other practice location 1

6228 Bradley Park Dr Ste A
Columbus, GA 31904-3605
Phone (706) 322-1486

Other identifiers 1

IdentifierTypeStateIssuer
254675MedicaidAL

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://dva-portal.et1087.epichosted.com/vpn/index.html

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20171010002067 AL Practitioner - Neurology 7113205642 Reassigns benefits to 1 organization
I20200820003398 AL Practitioner - Nephrology 7113205642 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nephrology
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Renal Associates of Alabama, LLCGroup PAC ID 7113271982, 13 clinicians

Practice addresses (Care Compare)

42 Mitylene Park Lane
Montgomery, AL 36117-7306
Phone (334) 603-6626

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
21.78 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
72.6

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Renal Associates of Montgomery, P.C. Nephrology CurrentSince Jul 31, 2017 Accepting new patients

Locations

4760 Woodmere Blvd
Montgomery, AL 36106
Phone (334) 288-0814

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/HGHAAA
  • Direct secure messaging: sumeet.munjal@direct.davitaphysiciansolutions.com

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

Hospital & facility affiliations 11

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": "1343347200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605225600000",
    "number": "1578819546",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "239 MITYLENE PARK DR",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361173547",
            "telephone_number": "706-322-1486",
            "fax_number": "706-324-3419"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "239 MITYLENE PARK DR",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361173547",
            "telephone_number": "334-603-6626",
            "fax_number": "706-324-3419"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6228 Bradley Park Dr Ste A",
            "address_purpose": "LOCATION",
            "city": "Columbus",
            "state": "GA",
            "postal_code": "319043605",
            "country_code": "US",
            "telephone_number": "706-322-1486",
            "fax_number": "706-324-3419",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MUNJAL",
        "first_name": "SUMEET",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-07-27",
        "last_updated": "2020-11-13",
        "certification_date": "2020-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "AL",
            "license": "MD.35005",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "254675",
            "state": "AL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://dva-portal.et1087.epichosted.com/vpn/index.html",
            "affiliation": "N",
            "endpointDescription": "Epic CKR EHR",
            "address_1": "239 Mitylene Park Dr",
            "city": "Montgomery",
            "state": "AL",
            "country_code": "US",
            "postal_code": "361173547",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Montgomery, AL

Sources for this page

Verify at the official NPI Registry.