Individual provider Active NPI

Anthony J. Tesoriero, M.D.

  • Internal Medicine Physician
  • Jasper, AL
National Provider Identifier
1598841462
Registry record updated Jun 18, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
30201 Issued in AL
Practice address
3400 Highway 78 E
Jasper, AL 35501-8956
Phone
(205) 387-4401
Fax
(205) 387-4717
NPI assigned
Oct 31, 2006
Last updated
Jun 18, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 158754 NY
Internal Medicine Physician 207R00000X 30201 AL Primary

Addresses

Primary practice location

3400 Highway 78 E
Jasper, AL 35501-8956

Mailing address

2359 Ridge TRL
Birmingham, AL 35242-3759

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
I20100712000480 AL Practitioner - Internal Medicine 8022182443 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
30201ALMDInternal Medicine Physician
158754NYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Baptist Health Centers, LLC Current Accepting new patients
Baptist Health Centers LLC CurrentSince Jul 1, 2019 Accepting new patients
Baptist Health Centers, LLC CurrentSince Jul 1, 2019 Accepting new patients
Saint Francis Hospital / Medicine Past Accepting new patients
Millbrook Medical Practice PC Past Accepting new patients

Locations

1130 22nd St S
Ste 1000
Birmingham, AL 35205
Phone (205) 518-8849

3400 Highway 78 E
Jasper, AL 35501
Phone (205) 387-4000

Organizations & group practices 5

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": "1162252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1434585600000",
    "number": "1598841462",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2359 RIDGE TRL",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352423759"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 HIGHWAY 78 E",
            "city": "JASPER",
            "state": "AL",
            "postal_code": "355018956",
            "telephone_number": "205-387-4401",
            "fax_number": "205-387-4717"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TESORIERO",
        "first_name": "ANTHONY",
        "middle_name": "J.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-31",
        "last_updated": "2015-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "158754",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AL",
            "license": "30201",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jasper, AL

Sources for this page

Verify at the official NPI Registry.