Southlake Orthopaedics – Orthopaedic Surgery Physician, NPI 1043268402
Orthopaedic Surgery Physician
Main info
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for Southlake Orthopaedics
4524 Southlake Pkwy Ste 26
Hoover, AL 352443272
Phone: (205) 329-7566
Fax: (888) 435-9974
Type: Location
3686 Grandview Pkwy Ste 430
Birmingham, AL 352433404
Phone: (205) 605-8180
Fax: (205) 972-8785
Type: Location
4517 SOUTHLAKE PKWY
BIRMINGHAM, AL 352443280
Phone: (205) 985-4111
Fax: (205) 985-4326
Type: Location
4517, Southlake Parkway, Southlake, Hoover, Shelby County, Alabama, 35244, United States
HOOVER, AL 352443280
Phone: (205) 985-4111
Fax: (205) 985-4326
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
Loading prescription activity...
Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
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: 2010-09-30
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Past revalidation due date
Earliest CMS due date was 2026-01-31 (130 days ago).
Enrollment records
2
Earliest due date
2026-01-31
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 |
|---|---|---|---|---|
| O20040505001364 | O | Clinic/Group Practice | AL | 2026-01-31 |
| O20100930016066 | O | Orthotic Personnel | AL | TBD |
What to do next
- Verify current status on the CMS Revalidation Lookup Tool immediately.
- Complete revalidation in PECOS or contact your Medicare Administrative Contractor (MAC).
- Overdue revalidation can lead to deactivation of Medicare billing privileges.
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 35244)
Loading plans...
Reviews
All reviews are moderated before publication. Reviews reflect users' opinions; we do not verify the accuracy of individual reviews.
No reviews yet. Be the first to share your experience — your opinion helps families compare providers.