BEVIN LYLE ELLENBERG (CRNP) – Primary Care Nurse Practitioner, NPI 1780100776
Primary Care Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
5,653 NURSE PRACTITIONER in AL
Provider Addresses for BEVIN LYLE ELLENBERG (CRNP)
3500 Highway 78 E
Jasper, AL 355018908
Phone: (205) 387-0333
Fax: (205) 387-9604
Type: Location
PO BOX 12366
BIRMINGHAM, AL 352022366
Phone: (205) 780-7101
Fax: (205) 206-8338
Type: Mailing
832, Princeton Avenue Southwest, Elyton, Birmingham, Jefferson County, Alabama, 35211, United States
BIRMINGHAM, AL 352111320
Phone: (205) 206-8450
Fax: (205) 206-8364
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 90 Open Payments records for all available years, with a total value of $2,408.
Total Amount is formed as General ($2,408) + Research ($0) + Ownership ($0) = $2,408.
Last reported payment date: 2024-12-17 • Largest payer in this snapshot: CTI BioPharma Corp. ($700).
Total Amount
$2,408
General + Research + Ownership
Payments
90
Total payment records
General Amount
$2,408
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-17
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| CTI BioPharma Corp. | $700 |
| Novartis Pharmaceuticals Corporation | $250 |
| Daiichi Sankyo Inc. | $196 |
| PFIZER INC. | $118 |
| Seagen Inc. | $82 |
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: 2017-11-29
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20171129002094 | I | Nurse Practitioner | AL | TBD |
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.
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.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| J0897 | Injection, denosumab, 1 mg | 5,580 | 56 | $0 |
| J1100 | Injection, dexamethasone sodium phosphate, 1 mg | 356 | 11 | $0 |
| 80053 | Blood test, comprehensive group of blood chemicals | 227 | 144 | $0 |
| 85025 | Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count | 221 | 130 | $0 |
| 36415 | Insertion of needle into vein for collection of blood sample | 219 | 146 | $0 |
Insurance plans in this area (ZIP 35501)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| P A T H O L O G Y | AL | |
| Internal Medicine, Medical Oncology, Hematology/Oncology | AL | |
| Nurse Practitioner | AL | |
| Hematology/Oncology, Hospice/Palliative Care, Internal Medicine | TN | |
| Hematology/Oncology, Internal Medicine | AL | |
| - | AL | |
| Nurse Practitioner | AL | |
| - | AL | |
| Nurse Practitioner | AL | |
| Medical Oncology, Hematology | AL |
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