NPIMap

Individual provider Active NPI

Syed R Aftab, MD

  • Psychiatry Physician
  • Jasper, AL
National Provider Identifier
1639119894
Registry record updated Jan 13, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
00025534 Issued in AL
Practice address
1100 7TH Ave
Jasper, AL 35501-4377
Phone
(205) 302-9000
NPI assigned
Jun 7, 2006
Last updated
Jan 13, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 00025534 AL Primary
Psychiatry Physician 2084P0800X 01066261A IN

Addresses

Primary practice location

1100 7TH Ave
Jasper, AL 35501-4377

Mailing address

1100 7TH Ave
Jasper, AL 35501-4377
Phone (205) 302-9000

Other identifiers 2

IdentifierTypeStateIssuer
332400600MedicaidAL
51523385OtherALBCBS OF AL

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040818001362 AL Practitioner - Psychiatry 9133192909 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1100 7TH Ave
Jasper, AL 35501-4377
Phone (205) 302-9000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
00025534ALMDPsychiatry Physician
01066261AINMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Tombigbee Healthcare Authority CurrentSince Dec 1, 2021 Accepting new patients
Northwest Alabama Mental Health Center CurrentSince Aug 1, 2010 Accepting new patients
Tombigbee Healthcare Authority CurrentSince Dec 1, 2021 Accepting new patients
Tombigbee Healthcare Authority Current Accepting new patients
Northwest Alabama Mental Health Center Psychiatry CurrentSince Aug 1, 2010 Accepting new patients
Eastside Mental Health Center Past Accepting new patients
BBH WBMC, LLC Past Accepting new patients
Eastside Mental Health Center Inc PastSince Oct 1, 2002 Accepting new patients
BBH WBMC, LLC Past Accepting new patients

Locations

105 US Highway 80 E
Demopolis, AL 36732
Phone (334) 287-2669

1100 7th Ave
Jasper, AL 35501
Phone (205) 302-9000

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

Organizations & group practices 9

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 5

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": "1149638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1326412800000",
    "number": "1639119894",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 7TH AVE",
            "city": "JASPER",
            "state": "AL",
            "postal_code": "355014377",
            "telephone_number": "205-302-9000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 7TH AVE",
            "city": "JASPER",
            "state": "AL",
            "postal_code": "355014377",
            "telephone_number": "205-302-9000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AFTAB",
        "first_name": "SYED",
        "middle_name": "R",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-07",
        "last_updated": "2012-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "AL",
            "license": "00025534",
            "primary": true
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IN",
            "license": "01066261A",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "332400600",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF AL",
            "identifier": "51523385",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jasper, AL

Sources for this page

Verify at the official NPI Registry.