Individual provider Active NPI

Mukul Mehra, MD

  • Gastroenterology Physician
  • Birmingham, AL
National Provider Identifier
1821053455
Registry record updated Oct 5, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
00026402 Issued in AL
Practice address
100 Pilot Medical Dr
Ste 225
Birmingham, AL 35235-3497
Phone
(205) 854-8404
Fax
(205) 854-4302
NPI assigned
Apr 18, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 5, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 00026402 AL Primary

Addresses

Primary practice location

100 Pilot Medical Dr
Ste 225
Birmingham, AL 35235-3497

Mailing address

100 Pilot Medical Dr
Ste 225
Birmingham, AL 35235-3497
Phone (205) 854-8404

Other identifiers 1

IdentifierTypeStateIssuer
51000763OtherBSBC

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
I20050622001431 AL Practitioner - GastroenterologyPractitioner - Internal Medicine 5294770954 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
00026402ALMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Gastroenterology Specialists of Birmingham,P.C. Gastroenterology Current Accepting new patients
Gastroenterology Associates of North-Central Alabama Inc CurrentSince Jun 1, 2016 Accepting new patients
Gastroenterology Associates of North-Central Alabama Inc CurrentSince Jun 1, 2016 Accepting new patients

Locations

100 Pilot Medical Dr
Ste 225
Birmingham, AL 35235
Phone (205) 854-8404

513 Brookwood Blvd
Ste 401
Birmingham, AL 35209
Phone (205) 663-1023

Organizations & group practices 3

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": "1145318400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1317772800000",
    "number": "1821053455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 PILOT MEDICAL DR",
            "address_2": "STE 225",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352353497",
            "telephone_number": "205-854-8404",
            "fax_number": "205-854-4302"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 PILOT MEDICAL DR",
            "address_2": "STE 225",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352353497",
            "telephone_number": "205-854-8404",
            "fax_number": "205-854-4302"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEHRA",
        "first_name": "MUKUL",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-04-18",
        "last_updated": "2011-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "AL",
            "license": "00026402",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BSBC",
            "identifier": "51000763",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Birmingham, AL

Sources for this page

Verify at the official NPI Registry.