Individual provider Active NPI

Bhanu Prakash Maturi, M.B.B.S.

  • Student in an Organized Health Care Education/Training Program
  • Houston, TX
National Provider Identifier
1790042802
Registry record updated May 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
License
V0470 Issued in TX
Practice address
6400 Fannin St Ste 2350
Houston, TX 77030-1554
Phone
(713) 704-4300
Fax
(713) 704-4355
NPI assigned
Apr 13, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 12, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 34528 AL
Student in an Organized Health Care Education/Training Program 390200000X V0470 TX Primary

Addresses

Primary practice location

6400 Fannin St Ste 2350
Houston, TX 77030-1554

Mailing address

1007 Old Breckenridge LN
Montgomery, AL 36117-8952
Phone (334) 777-9303

Other practice location 1

2055 E South Blvd
Montgomery, AL 36116-2001
Phone (334) 551-2002

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
I20150803000237 AL Practitioner - Internal Medicine 4688988827 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
34528ALMDInternal Medicine Physician
V0470TXMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Pinnacle Physician Group, LLP Internal Medicine CurrentSince Mar 1, 2023 Accepting new patients
Health Care Authority for Baptist Health, an Affiliate of Uabhs CurrentSince Oct 26, 2021 Accepting new patients
Health Care Authority for Baptist Health, an Affiliate of Uabhs Internal Medicine CurrentSince Oct 26, 2021 Accepting new patients
Health Care Authority for Baptist Health, an Affiliate of Uabhs Current Accepting new patients
Ut Physicians Internal Medicine PastSince May 7, 2024 Accepting new patients

Locations

2055 E South Blvd
Ste 308
Montgomery, AL 36116
Phone (334) 286-2390

400 Taylor Rd
Montgomery, AL 36117
Phone (334) 213-6287

301 Brown Springs Rd
Montgomery, AL 36117
Phone (334) 273-4159

2055 E South Blvd
Ste 200
Montgomery, AL 36116
Phone (334) 284-5211

2700 Hospital Dr
Northport, AL 35476
Phone (205) 333-4500

124 S Memorial Dr
Prattville, AL 36067
Phone (334) 361-4267

809 University Blvd E
Tuscaloosa, AL 35401
Phone (205) 333-4661

1655 McFarland Blvd N
Tuscaloosa, AL 35406
Phone (205) 301-8930

Interoperability endpoints

  • Direct secure messaging: bhanu.maturi@direct.baptistfirst.org

Organizations & group practices 6

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1334275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715472000000",
    "number": "1790042802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1007 OLD BRECKENRIDGE LN",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361178952",
            "telephone_number": "334-777-9303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6400 FANNIN ST STE 2350",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770301554",
            "telephone_number": "713-704-4300",
            "fax_number": "713-704-4355"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2055 E South Blvd",
            "address_purpose": "LOCATION",
            "city": "Montgomery",
            "state": "AL",
            "postal_code": "361162001",
            "country_code": "US",
            "telephone_number": "334-551-2002",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MATURI",
        "first_name": "BHANU",
        "middle_name": "PRAKASH",
        "credential": "M.B.B.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-04-13",
        "last_updated": "2024-05-12",
        "certification_date": "2024-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AL",
            "license": "34528",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "TX",
            "license": "V0470",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.