PRIYA NETHALA – Student in an Organized Health Care Education/Training Program, NPI 1417417866

PRIYA NETHALA is a healthcare provider. based in Birmingham, Alabama. specializing in GASTROENTEROLOGY. The NPI Number for PRIYA NETHALA is 1417417866

Main info

Female
7 Years Of Experience
Accepts Medicare Assignment
Name
PRIYA NETHALA
NPI
1417417866
Phone
(205) 934-9666
Address
625 19TH ST S
Enumeration Date
21 March 2019
Last Update Date
21 March 2019

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2482739930
Graduation Year
2019 (7 years ago)
PAC ID
8921349739
Group Practice PAC ID
4880590264
Professional Enrollment ID
I20250813000151
Address ID
MI480845458TR264XXRDXX402
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience19
Completeness75
Years active:7State licenses:0Digital endpointsOther names

239 GASTROENTEROLOGY in AL

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Provider Addresses for PRIYA NETHALA

  • 625, 19th Street South, Phelan Park Historic District, Five Points South, Birmingham, Jefferson County, Alabama, 35233, United States

    BIRMINGHAM, AL 352331900

    Phone: (205) 934-9666

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 1 Open Payments records for all available years, with a total value of $77.

Total Amount is formed as General ($77) + Research ($0) + Ownership ($0) = $77.

Last reported payment date: 2023-01-11 • Largest payer in this snapshot: E.R. Squibb & Sons, L.L.C. ($77).

Total Amount

$77

General + Research + Ownership

Payments

1

Total payment records

General Amount

$77

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2023-01-11

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2025-08-13

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20250813000151IGastroenterologyMITBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 35233)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 4880590264View full group profile
NameSpecialtyState
-MI
G A S T R O E N T E R O L O G YMI
-MI
Nurse PractitionerMI
G A S T R O E N T E R O L O G YMI
Physician AssistantMI
Internal Medicine, GastroenterologyMI
Nurse PractitionerMI
Nurse PractitionerMI
Physician AssistantMI

Reviews

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Frequently asked questions

Does PRIYA NETHALA share an NPI with anyone else?
NPI numbers are unique to each provider or organization — PRIYA NETHALA uses 1417417866.
Can I rely on PRIYA NETHALA being an active provider?
As of the registry snapshot, PRIYA NETHALA is marked active.
What taxonomy line describes PRIYA NETHALA?
For research purposes, treat PRIYA NETHALA as Student in an Organized Health Care Education/Training Program in this dataset. Clinical services aligned with this taxonomy classification.
Does PRIYA NETHALA list a practice location?
Patients near Birmingham, Alabama may find PRIYA NETHALA in results; validate coverage separately.
How many locations tie to this NPI?
2 practice locations appear in the available data.

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