Individual provider Active NPI

Brendan C Anzalone, DO

  • Emergency Medicine Physician
  • Birmingham, AL
National Provider Identifier
1700954088
Registry record updated Jun 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
DO.1159 Issued in AL
Practice address
1806 6TH Ave S
Birmingham, AL 35233-1932
Phone
(205) 975-7388
NPI assigned
Dec 2, 2006
Last updated
Jun 29, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X DO.1159 AL Primary
Emergency Medicine Physician 207P00000X 1159 AL
Emergency Medicine Physician 207P00000X 2006-01308 NC

Addresses

Primary practice location

1806 6TH Ave S
Birmingham, AL 35233-1932

Mailing address

PO Box 11407 Drawer 624
Birmingham, AL 35246-0624

Other practice location 1

619 19th St S
Birmingham, AL 35233-1900
Phone (205) 934-5105

Other identifiers 4

IdentifierTypeStateIssuer
Z12062OtherALVIVA HEALTH
122963MedicaidAL
1700954088OtherALTRICARE SOUTH
511-10189OtherALBCBS

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address banzalone@direct.uabmedicine.org Direct University of Alabama Hospital

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
I20101112000982 AL Practitioner - Emergency Medicine 8820283096 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
DO.1159ALMDEmergency Medicine Physician
2006-01308NCMDEmergency Medicine Physician
1159ALMDPediatric Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
University of Alabama Health Services Foundation, PC. CurrentSince Mar 1, 2016 Accepting new patients
University of Alabama at Birmingham Current Accepting new patients
University of Alabama at Birmingham Emergency Medicine CurrentSince Sep 7, 2010 Accepting new patients
University of Alabama at Birmingham CurrentSince Sep 7, 2010 Accepting new patients

Locations

1201 11th Ave S
Birmingham, AL 35205
Phone (205) 930-7100

1806 6th Ave S
Birmingham, AL 35233
Phone (205) 939-9587

619 19th St S
Birmingham, AL 35233
Phone (205) 934-6405

619 19th St S
Birmingham, AL 35249

619 19th St S
#251
Birmingham, AL 35249
Phone (205) 975-7387

1806 6th Ave S
Irondale, AL 35210
Phone (205) 975-7389

Interoperability endpoints

  • Direct secure messaging: banzalone@direct.uabmedicine.org

Organizations & group practices 4

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": "1165017600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687996800000",
    "number": "1700954088",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 11407 DRAWER 624",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352460624"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1806 6TH AVE S",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352331932",
            "telephone_number": "205-975-7388"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "619 19th St S",
            "address_purpose": "LOCATION",
            "city": "Birmingham",
            "state": "AL",
            "postal_code": "352331900",
            "country_code": "US",
            "telephone_number": "205-934-5105",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ANZALONE",
        "first_name": "BRENDAN",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-02",
        "last_updated": "2023-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "AL",
            "license": "DO.1159",
            "primary": true
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "AL",
            "license": "1159",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NC",
            "license": "2006-01308",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VIVA HEALTH",
            "identifier": "Z12062",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "122963",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE SOUTH",
            "identifier": "1700954088",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "511-10189",
            "state": "AL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "banzalone@direct.uabmedicine.org",
            "affiliation": "Y",
            "affiliationName": "University of Alabama Hospital",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "619 19th St S",
            "city": "Birmingham",
            "state": "AL",
            "country_code": "US",
            "postal_code": "352331900",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Birmingham, AL

Sources for this page

Verify at the official NPI Registry.