Active NPI
Calin G Braicu, MD
- Family Medicine Physician
- Montgomery, AL
National Provider Identifier
1689759748
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 13128
- Practice address
- 4505 Executive Park Dr
Montgomery, AL 36116-1601 - Phone
- (334) 244-7737
- NPI assigned
- Oct 26, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 13128 | AL | Primary |
Addresses
Primary practice location
4505 Executive Park Dr
Montgomery, AL 36116-1601
Mailing address
2257 Taylor Rd
Suite 200
Montgomery, AL 36117-7790
Phone (334) 270-9914
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00080984 | Medicaid | AL | |
| 51080984 | Other | AL | BLUE CROSS |
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20101020000628 | AL | Practitioner - Family Practice | 6406049683 | Practice locations: Montgomery, AL |
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- Education
- Other, 1979
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
4505 Executive Park Dr
Montgomery, AL 36116-1601
Phone (334) 244-7737
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 13128 | AL | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161820800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1689759748",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2257 TAYLOR RD",
"address_2": "SUITE 200",
"city": "MONTGOMERY",
"state": "AL",
"postal_code": "361177790",
"telephone_number": "334-270-9914",
"fax_number": "334-270-3195"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4505 EXECUTIVE PARK DR",
"city": "MONTGOMERY",
"state": "AL",
"postal_code": "361161601",
"telephone_number": "334-244-7737"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRAICU",
"first_name": "CALIN",
"middle_name": "G",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-10-26",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "AL",
"license": "13128",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00080984",
"state": "AL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS",
"identifier": "51080984",
"state": "AL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Montgomery, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.