Individual provider Active NPI

Peter Pavlidakey, M.D.

  • Dermatopathology (Pathology) Physician
  • Birmingham, AL
National Provider Identifier
1871757856
Registry record updated Oct 7, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatopathology (Pathology) PhysicianTaxonomy code 207ZD0900X
License
31123 Issued in AL
Practice address
619 19TH St S
Birmingham, AL 35249
Phone
(205) 934-4011
NPI assigned
Jul 18, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatopathology (Pathology) Physician 207ZD0900X 31123 AL Primary

Addresses

Primary practice location

619 19TH St S
Birmingham, AL 35249

Mailing address

PO Box 55310
Birmingham, AL 35255-5310

Other practice location 1

9780 Maumelle Blvd
North Little Rock, AR 72113-6737
Phone (501) 753-9000

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
I20150721002894 AL Practitioner - PathologyPractitioner - Dermatology 5799921508 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
PathologyAlso: Dermatology
Education
Northeastern Ohio University College of Medicine, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

619 19TH St S
Birmingham, AL 35249-1900
Phone (205) 934-4011

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
98.67 of 100Reported as apm
Quality
80.18
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
University of Alabama Health Services Foundation, PC. CurrentSince Jun 12, 2015 Accepting new patients

Locations

619 19th St S
Birmingham, AL 35249

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

2000 6th Ave S
Birmingham, AL 35233
Phone (205) 731-9396

Interoperability endpoints

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

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 and National Provider Directory roles.

Hospital & facility affiliations 2

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": "1216339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1570406400000",
    "number": "1871757856",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 55310",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352555310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "619 19TH ST S",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "35249",
            "telephone_number": "205-934-4011"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9780 Maumelle Blvd",
            "address_purpose": "LOCATION",
            "city": "North Little Rock",
            "state": "AR",
            "postal_code": "721136737",
            "country_code": "US",
            "telephone_number": "501-753-9000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PAVLIDAKEY",
        "first_name": "PETER",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-07-18",
        "last_updated": "2019-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZD0900X",
            "taxonomy_group": "",
            "desc": "Pathology, Dermatopathology",
            "state": "AL",
            "license": "31123",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Birmingham, AL

Sources for this page

Verify at the official NPI Registry.