Individual provider Active NPI

Julian Mahaganasan, MD

  • Specialist
  • Birmingham, AL
National Provider Identifier
1942267117
Registry record updated Jun 27, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
24516 Issued in AL
Practice address
50 Medical Park Dr E
St. Vincent'S East
Birmingham, AL 35235-3401
Phone
(205) 545-9530
Fax
(205) 545-9529
NPI assigned
Apr 28, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 27, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 24516 AL Primary

Addresses

Primary practice location

50 Medical Park Dr E
St. Vincent'S East
Birmingham, AL 35235-3401

Mailing address

2016 Stonegate TRL
Suite 112
Vestavia Hills, AL 35242-2260
Phone (205) 545-9530

Other identifiers 1

IdentifierTypeStateIssuer
051555550MedicaidAL

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
I20040524000918 AL Practitioner - Emergency Medicine 2264423581 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Emergency Services of Montgomery PCGroup PAC ID 6608028204, 61 clinicians

Practice addresses (Care Compare)

124 S Memorial Dr
Prattville, AL 36067-3619
Phone (334) 365-0651

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
24516ALMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Kulturecity Current Accepting new patients
Emergency Services of Montgomery PC CurrentSince Nov 1, 2012 Accepting new patients
Hospital Medicine Associates LLC Family Medicine Past Accepting new patients
Premier Medical Past Accepting new patients

Locations

400 Taylor Rd
Montgomery, AL 36117
Phone (334) 213-6287

2105 E South Blvd
Montgomery, AL 36116
Phone (334) 286-2842

124 S Memorial Dr
Prattville, AL 36067
Phone (334) 361-4267

Interoperability endpoints

  • FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.441.1262
  • Direct secure messaging: julian.maha@direct.baptistfirst.org

Organizations & group practices 4

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 1

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": "1146182400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1214524800000",
    "number": "1942267117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2016 STONEGATE TRL",
            "address_2": "SUITE 112",
            "city": "VESTAVIA HILLS",
            "state": "AL",
            "postal_code": "352422260",
            "telephone_number": "205-545-9530"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 MEDICAL PARK DR E",
            "address_2": "ST. VINCENT'S EAST",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352353401",
            "telephone_number": "205-545-9530",
            "fax_number": "205-545-9529"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAHAGANASAN",
        "first_name": "JULIAN",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-04-28",
        "last_updated": "2008-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "AL",
            "license": "24516",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "051555550",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Birmingham, AL

Sources for this page

Verify at the official NPI Registry.