MR. SUDHA SAGAR BENNURI (MD) – Pediatrics Physician, NPI 1619076866
Pediatrics Physician
Main info
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for MR. SUDHA SAGAR BENNURI (MD)
2701 20TH AVENUE
NORTHPORT, AL 354763832
Phone: (205) 333-8900
Fax: (205) 333-6090
Type: Mailing
920, Rose Drive, Northport, Tuscaloosa County, Alabama, 35476, United States
NORTHPORT, AL 35476
Phone: (205) 333-5900
Fax: (205) 333-6090
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 4 Open Payments records for all available years, with a total value of $117.
Total Amount is formed as General ($117) + Research ($0) + Ownership ($0) = $117.
Last reported payment date: 2024-09-14 • Largest payer in this snapshot: Genentech USA, Inc. ($64).
Total Amount
$117
General + Research + Ownership
Payments
4
Total payment records
General Amount
$117
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-09-14
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Genentech USA, Inc. | $64 |
| Tris Pharma Inc | $23 |
| GlaxoSmithKline, LLC. | $17 |
| Supernus Pharmaceuticals, Inc. | $13 |
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: 2016-12-14
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 |
|---|---|---|---|---|
| I20161214000302 | I | Pediatric Medicine | 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.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 35476)
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