Mr Sudha Sagar Bennuri, MD in Northport, AL

Mr Sudha Sagar Bennuri, MD is a medicare enrolled "Pediatrics" physician in Northport, Alabama. His current practice location is 2701 20th Avenue, Northport, Alabama. You can reach out to his office (for appointments etc.) via phone at (205) 333-5900.

Mr Sudha Sagar Bennuri is licensed to practice in Alabama (license number 22564) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1619076866.

Contact Information

	Mr Sudha Sagar Bennuri, MD
	2701 20th Avenue, Northport, AL 35476-3832
	(205) 333-5900
	(205) 333-6090

Map and Direction

Physician's Profile

Full Name	Mr Sudha Sagar Bennuri
Gender	Male
Speciality	Pediatrics
Location	2701 20th Avenue, Northport, Alabama
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1619076866
Provider Enumeration Date: 09/22/2006
Last Update Date: 03/14/2023

Medicare PECOS Information:

PECOS PAC ID: 5799736542
Enrollment ID: I20161214000302

Medical Identifiers

Medical identifiers for Mr Sudha Sagar Bennuri such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1619076866	NPI	-	NPPES
009978025	Medicaid	AL

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
208000000X	Pediatrics	22564 (Alabama)	Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Mr Sudha Sagar Bennuri allows following entities to bill medicare on his behalf.

Entity Name	Bama Pedicatrics Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1720137334 PECOS PAC ID: 0244281459 Enrollment ID: O20050204000558

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mr Sudha Sagar Bennuri is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Mr Sudha Sagar Bennuri, MD 2701 20th Avenue, Northport, AL 35476-3832 Ph: (205) 333-8900	Mr Sudha Sagar Bennuri, MD 2701 20th Avenue, Northport, AL 35476-3832 Ph: (205) 333-5900

Mr Sudha Sagar Bennuri, MD - Medicare Pediatrics in Northport, AL