Individual provider Active NPI

Shajan Peter

  • Gastroenterology Physician
  • Birmingham, AL
National Provider Identifier
1871765552
Registry record updated Oct 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
L.3058SP Issued in AL
Practice address
1717 6TH Ave S
Birmingham, AL 35233-1801
Phone
(800) 822-8816
NPI assigned
Apr 2, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2022

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 L.3058SP AL Primary

Addresses

Primary practice location

1717 6TH Ave S
Birmingham, AL 35233-1801

Mailing address

1717 6TH Ave S
Birmingham, AL 35233-1801

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
I20080523000153 AL Practitioner - Gastroenterology 1254400708 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University of Alabama Health Services Foundation, PCGroup PAC ID 1951213107, 2,784 clinicians

Practice addresses (Care Compare)

2000 6TH Ave S
Birmingham, AL 35233-2110
Phone (205) 937-9999

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

Hospital & facility affiliations

  • University of Alabama Hospital Hospital, Birmingham, AL, CCN 010033

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy90
Upper gastrointestinal (GI) endoscopy for acid reflux340

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
L.3058SPALMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Alabama Health Services Foundation, PC. CurrentSince Jun 12, 2013 Accepting new patients

Locations

1720 2nd Ave S
Birmingham, AL 35294
Phone (205) 801-7801

1717 6th Ave S
Birmingham, AL 35233
Phone (205) 934-3450

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

619 19th St S
Birmingham, AL 35249

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

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": "1207094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666656000000",
    "number": "1871765552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1717 6TH AVE S",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352331801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1717 6TH AVE S",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352331801",
            "telephone_number": "800-822-8816"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETER",
        "first_name": "SHAJAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-04-02",
        "last_updated": "2022-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "AL",
            "license": "L.3058SP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Birmingham, AL

Sources for this page

Verify at the official NPI Registry.