| Trevor Alden Lundstrom, MD | |
|
4517 Southlake Pkwy, Hoover, AL 35244-3280 | |
| (205) 985-4111 | |
| (205) 985-4326 |
| Full Name | Trevor Alden Lundstrom |
|---|---|
| Gender | Male |
| Speciality | Diagnostic Radiology |
| Experience | 26 Years |
| Location | 4517 Southlake Pkwy, Hoover, Alabama |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619930047 | NPI | - | NPPES |
| 51529306 | Other | AL | BLUE CROSS BLUE SHIELD |
| 51527709 | Other | AL | BLUE CROSS/BLUE SHIELD |
| 051529306 | Medicaid | AL | |
| 51527723 | Other | AL | BLUE CROSS/BLUE SHIELD |
| 009998935 | Medicaid | AL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2085R0202X | Radiology - Diagnostic Radiology | 23792 (Alabama) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| St Vincent's Birmingham | Birmingham, AL | Hospital |
| Brookwood Baptist Medical Center | Birmingham, AL | Hospital |
| Russell Medical Center | Alexander city, AL | Hospital |
| St Vincent's St Clair | Pell city, AL | Hospital |
| St Vincents Blount | Oneonta, AL | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Cooper Green Mercy Health Services Authority An Affiliate Of Uab | 0840629473 | 58 |
| Southern Orthopaedic Alliance Pllc | 2365800604 | 98 |
| Radiology Associates Of Birmingham, P.c. | 7214928571 | 42 |
| Radiology Associates Of Birmingham, P.c. | 7214928571 | 42 |
| Entity Name | University Of Alabama Health Services Foundation, Pc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1093768723 PECOS PAC ID: 1951213107 Enrollment ID: O20031105000261 |
| Entity Name | Norwood Clinic Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1104879741 PECOS PAC ID: 8921996364 Enrollment ID: O20040308001107 |
| Entity Name | Southlake Orthopaedics Sports Medicine & Spine Center, Pc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1043268402 PECOS PAC ID: 9335137470 Enrollment ID: O20040505001364 |
| Entity Name | Radiology Associates Of Birmingham, P.c. |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1093778706 PECOS PAC ID: 7214928571 Enrollment ID: O20040524001193 |
| Entity Name | Urology Centers Of Alabama, Pc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1710962550 PECOS PAC ID: 0941264345 Enrollment ID: O20041116000389 |
| Entity Name | Coastal Neurological Institute Pc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1740212174 PECOS PAC ID: 4688617699 Enrollment ID: O20050609000711 |
| Entity Name | St Vincents Ambulatory Healthcare Network Llc |
|---|---|
| Entity Type | Part B Supplier - Independent Diagnostic Testing Facility (idtf) |
| Entity Identifiers | NPI Number: 1588190441 PECOS PAC ID: 1355608456 Enrollment ID: O20171128001387 |
| Entity Name | St Vincents Ambulatory Healthcare Network Llc |
|---|---|
| Entity Type | Part B Supplier - Independent Diagnostic Testing Facility (idtf) |
| Entity Identifiers | NPI Number: 1033646823 PECOS PAC ID: 1355608456 Enrollment ID: O20180626000597 |
| Entity Name | Cooper Green Mercy Health Services Authority An Affiliate Of Uab |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1366073108 PECOS PAC ID: 0840629473 Enrollment ID: O20200402003238 |
| Entity Name | Southern Orthopaedic Alliance Pllc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1588364228 PECOS PAC ID: 2365800604 Enrollment ID: O20230620001264 |
| Mailing Address | Practice Location Address |
|---|---|
| Trevor Alden Lundstrom, MD 4517 Southlake Pkwy, Hoover, AL 35244-3280 Ph: (205) 985-4111 | Trevor Alden Lundstrom, MD 4517 Southlake Pkwy, Hoover, AL 35244-3280 Ph: (205) 985-4111 |
Allen Benensohn Oser, M.D. Radiology Medicare: Accepting Medicare Assignments Practice Location: 4517 Southlake Pkwy Ste 4400, Hoover, AL 35244 Phone: 205-985-4111 | |
Dr. Jeffrey Ryne Black, MD Radiology Medicare: Accepting Medicare Assignments Practice Location: 4517 Southlake Pkwy, Hoover, AL 35244 Phone: 205-985-4111 Fax: 205-985-4326 | |
Dr. Shane Adam Wear, MD Radiology Medicare: Accepting Medicare Assignments Practice Location: 4517 Southlake Pkwy, Hoover, AL 35244 Phone: 205-985-4111 Fax: 205-985-4326 | |
Dr. Frederick Albert Kebbel V, M.D. Radiology Medicare: Accepting Medicare Assignments Practice Location: 4517 Southlake Pkwy, Hoover, AL 35244 Phone: 205-985-4111 Fax: 205-985-4326 | |
Harry Benjamin Rosenthal Iii, M.D. Radiology Medicare: Accepting Medicare Assignments Practice Location: 4517 Southlake Pkwy, Hoover, AL 35244 Phone: 205-985-4111 Fax: 205-985-4326 | |
Dr. Barrett Patrick Cary, MD Radiology Medicare: Accepting Medicare Assignments Practice Location: 4517 Southlake Pkwy, Hoover, AL 35244 Phone: 205-985-4111 Fax: 205-985-4326 |