NPIMap

Individual provider Active NPI

Adeel A Bodla, MD

  • Adult Medicine Physician
  • Madison, AL
National Provider Identifier
1679770267
Registry record updated Aug 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Medicine PhysicianTaxonomy code 207QA0505X
License
MD30833 Issued in AL
Practice address
400 Sun Temple Dr
Madison, AL 35758-5924
Phone
(256) 774-5524
Fax
(256) 774-5523
NPI assigned
Jun 28, 2007
Last updated
Aug 15, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 15, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Medicine Physician 207QA0505X MD30833 AL Primary

Addresses

Primary practice location

400 Sun Temple Dr
Madison, AL 35758-5924

Mailing address

400 Sun Temple Dr Ste D
Madison, AL 35758-5924
Phone (256) 774-5524

Other practice location 1

610 Airport Rd SW Ste 100
Huntsville, AL 35802-4304
Phone (256) 429-4809

Other identifiers 1

IdentifierTypeStateIssuer
129305MedicaidAL

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
I20110412000119 AL Practitioner - Family Practice 5799838819 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Madison Primary Care LLCGroup PAC ID 0042494346, 6 clinicians

Practice addresses (Care Compare)

400 Sun Temple Dr
Madison, AL 35758-5924
Phone (256) 774-5524

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
95.45 of 100Reported as apm
Quality
90.9
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
0 of 100Reported as group
Quality
0
Promoting interoperability
0
Improvement activities
0
Cost
0

National Provider Directory

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

Interoperability endpoints

  • Direct secure messaging: adeel.bodla.1@12216.direct.athenahealth.com

Organizations & group practices 1

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 8

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": "1182988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692057600000",
    "number": "1679770267",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 SUN TEMPLE DR STE D",
            "city": "MADISON",
            "state": "AL",
            "postal_code": "357585924",
            "telephone_number": "256-774-5524",
            "fax_number": "256-774-5523"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 SUN TEMPLE DR",
            "city": "MADISON",
            "state": "AL",
            "postal_code": "357585924",
            "telephone_number": "256-774-5524",
            "fax_number": "256-774-5523"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "610 Airport Rd SW Ste 100",
            "address_purpose": "LOCATION",
            "city": "Huntsville",
            "state": "AL",
            "postal_code": "358024304",
            "country_code": "US",
            "telephone_number": "256-429-4809",
            "fax_number": "256-429-4163",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BODLA",
        "first_name": "ADEEL",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-06-28",
        "last_updated": "2023-08-15",
        "certification_date": "2023-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QA0505X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Adult Medicine",
            "state": "AL",
            "license": "MD30833",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "129305",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison, AL

Sources for this page

Verify at the official NPI Registry.