Individual provider Active NPI

Abhinit Singh Jawanda, MD

  • Family Medicine Physician
  • Birmingham, AL
National Provider Identifier
1649794025
Registry record updated Sep 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD61014054 Issued in WA
Practice address
625 19TH St S
Birmingham, AL 35249-6750
Phone
(334) 874-3463
Fax
(334) 874-3511
NPI assigned
Jul 27, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2021

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 MD61014054 WA Primary

Addresses

Primary practice location

625 19TH St S
Birmingham, AL 35249-6750

Mailing address

625 19TH St S
Birmingham, AL 35233-1900

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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
I20200914002345 WA Practitioner - Family Practice 7517233570 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

400 NE Mother Joseph PL
Vancouver, WA 98664-3200
Phone (360) 514-3727

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD61014054WAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
South Sound Inpatient Physicians PLLC Family Medicine CurrentSince Aug 12, 2020 Accepting new patients
Cogent Healthcare of Washington, PC Family Medicine CurrentSince Apr 2, 2022 Accepting new patients
South Sound Inpatient Physicians PLLC Family Medicine Current Accepting new patients
South Sound Inpatient Physicians PLLC Family Medicine CurrentSince Aug 12, 2020 Accepting new patients
Peacehealth Family Medicine Past Accepting new patients

Locations

5410 Maryland Way
Ste 300
Brentwood, TN 37027
Phone (615) 377-1674

407 14th Ave SE
Puyallup, WA 98372
Phone (253) 697-4000

2000 Hospital Dr
Sedro Woolley, WA 98284
Phone (360) 856-6021

400 NE Mother Joseph Pl
Vancouver, WA 98664
Phone (360) 514-2000

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 and National Provider Directory roles.

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": "1501113600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632182400000",
    "number": "1649794025",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "625 19TH ST S",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352331900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "625 19TH ST S",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352496750",
            "telephone_number": "334-874-3463",
            "fax_number": "334-874-3511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAWANDA",
        "first_name": "ABHINIT",
        "middle_name": "SINGH",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-07-27",
        "last_updated": "2021-09-21",
        "certification_date": "2021-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "MD61014054",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Birmingham, AL

Sources for this page

Verify at the official NPI Registry.