Birmingham Surgical, P.C.
Organization Active NPI Surgery Physician · Birmingham, AL
NPI 1922068774 · NPPES record last updated Jun 21, 2018
Key facts
- NPI
- 1922068774
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Surgery Physician 208600000X
- Legal business name
- BIRMINGHAM SURGICAL, P.C.
- Practice address
- 2022 Brookwood Medical Ctr Dr
Suite 313 Acc
Birmingham, AL 35209-6808 - Phone
- (205) 877-2910
- Fax
- (205) 879-4649
- NPI assigned
- Mar 24, 2006
- Organization subpart
- No
Authorized official
- Name
- Mr. Brian Derek Lasker, MBA
- Title
- Administrator
- Phone
- (205) 877-2910
Corporate family (same tax ID) 1
Practitioners 5
-
Brendon Haikes, MD
-
Mimi Chamblin Smith, M.D.
-
Jaime Bitran, M.D.
-
Daniel Mirelman, M.D.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in AL
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040706000341 | AL | Part B Supplier - Clinic/Group Practice | 3779560081 |
Receives reassigned benefits from 3 practitioners Practice locations: Birmingham, AL; Oneonta, AL |
National Provider Directory
- Tax ID family
- Birmingham Surgical
Locations
832 Princeton Ave SW
Fl 3
Birmingham, AL 35211
Phone (205) 206-8323
150 Gilbreath Dr
Oneonta, AL 35121
Phone (205) 274-3000
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician |
208600000X | Yes |
Addresses
Primary practice location
2022 Brookwood Medical Ctr Dr
Suite 313 Acc
Birmingham, AL 35209-6808
Mailing address
2022 Brookwood Medical Ctr Dr
Suite 313 Acc
Birmingham, AL 35209-6808
Phone (205) 877-2910
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| C321 | Other | AL | BROUP BILLING BLUE CROSS |
| 1043279797 | Other | AL | NPI |
| 1457311250 | Other | AL | NPI |
| 528500610 | Medicaid | AL | |
| 1750341756 | Other | AL | NPI |
| 1922068774 | Other | GROUP NPI | |
| 1306805825 | Other | AL | NPI |
| 1326008129 | Other | AL | NPI |
| 1780644591 | Other | AL | NPI |
| CM7410 | Other | GROUP RAILROAD MEDICARE |
Other providers in Birmingham, AL
- Birmingham Regional Paratransit
- Birmingham SNF Opco LLC
- Birmingham Speech & Hearing Assoc
- Birmingham Speech & Hearing Associates
- Birmingham Surgery Center, LLC
- Birmingham Therapy Services, LLC
- Birmingham VA Medical Center
- Birmingham VA Medical Center
- Birmingham VA Medical Center
- Birmingham VA Medical Center
All providers in Birmingham, AL · Surgery Physician in Alabama
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 21, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.