Individual provider Active NPI

Natalie Ann Derise, MD

  • Otolaryngology Physician
  • Birmingham, AL
National Provider Identifier
1922505643
Registry record updated Sep 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
MD.39063 Issued in AL
Practice address
619 19TH St S
Birmingham, AL 35233-1900
Phone
(205) 934-4011
NPI assigned
Apr 9, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X MD.39063 AL Primary

Addresses

Primary practice location

619 19TH St S
Birmingham, AL 35233-1900

Mailing address

PO Box 55310
Birmingham, AL 35255-5310
Phone (205) 731-9701

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA, AL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20230609000943 WA Practitioner - Otolaryngology 2567829336 Reassigns benefits to 3 organizations
I20241009003051 AL Practitioner - Otolaryngology 2567829336 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
Louisiana State University School of Medicine in Shreveport, 2018
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

Hospital & facility affiliations

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

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision23
Skin biopsy1-10

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 Oct 1, 2024 Accepting new patients
The Association of Chrmc and University Physicians Otolaryngology CurrentSince Jun 9, 2023 Accepting new patients
The Association of University Physicians CurrentSince Jun 5, 2023 Accepting new patients
Association of CHMC and University Physicians CurrentSince Jun 9, 2023 Accepting new patients
Valley Medical Group-Renton CurrentSince Jul 1, 2023 Accepting new patients

Locations

1201 11th Ave S
Birmingham, AL 35205
Phone (205) 930-7100

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

720 39th St N
Birmingham, AL 35222

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

619 19th St S
Birmingham, AL 35249

16850 SE 272nd St
Ste 100
Covington, WA 98042
Phone (253) 395-1971

900 Pacific Ave
Ste 100
Everett, WA 98201
Phone (425) 304-6080

4011 Talbot Rd S
Ste 210
Renton, WA 98055
Phone (425) 255-4250

4011 Talbot Rd S
Ste 420
Renton, WA 98055
Phone (425) 251-1322

4800 Sand Point Way NE
Seattle, WA 98105
Phone (206) 526-2000

1959 NE Pacific St
Seattle, WA 98195
Phone (206) 598-4333

Organizations & group practices 5

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": "1523232000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727136000000",
    "number": "1922505643",
    "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",
            "telephone_number": "205-731-9701"
        },
        {
            "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": "352331900",
            "telephone_number": "205-934-4011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DERISE",
        "first_name": "NATALIE",
        "middle_name": "ANN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-09",
        "last_updated": "2024-09-24",
        "certification_date": "2024-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "AL",
            "license": "MD.39063",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Birmingham, AL

Sources for this page

Verify at the official NPI Registry.