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THE KIDNEY CLINIC
NPI 1639487564
Internal Medicine - Nephrology in Bentonville, AR

Active since September 14, 2010
2618 SE J ST, SUITE#4, BENTONVILLE, AR 72712(479) 271-9393(479) 271-9393 Get Directions Write a Review

NPPES record last updated: March 2, 2016. Verified against the NPPES registry weekly; last sync: November 08, 2026.

Record update history: Mar 2, 2016, Sep 28, 2015 (2 updates tracked since 2015).

About The Kidney Clinic NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

THE KIDNEY CLINIC (NPI 1639487564) is a healthcare organization registered as a nephrology in Bentonville, Arkansas and active in the NPI registry since September 2010. The organization lists Shamsul Alam, President, as its authorized official.

NPPES Registry Identity

NPI1639487564
Entity TypeOrganization
Primary Taxonomy207RN0300X
Legal Business NameSHAMSUL ALAM MD PA
Location Address2618 SE J ST, SUITE#4Bentonville, AR 72712-3767
Mailing AddressPo Box 1037Bentonville, AR 72712-1037 · (479) 271-9393 · Fax (479) 271-0141
Phone(479) 271-9393
Fax(479) 271-9393
Organization SubpartNo
Authorized OfficialShamsul AlamPresident · (479) 271-9393
Enumeration DateSeptember 14, 2010
Last NPPES UpdateMarch 2, 20162 updates tracked since enumeration
✔ NPI 1639487564 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · NephrologyAllopathic & Osteopathic Physicians
Taxonomy Code207RN0300X
License✔ Licensed in AR · E4954
Definition
An internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation.
2618 SE J ST, Bentonville, AR 72712
Open in Google Maps ↗

Other Names 1

Doing Business AsThe Kidney Clinic

Other Identifiers 1

Other5G686Medicare Group Ptan

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

The Kidney Clinic is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

3

Medicare enrollment records show 3 clinicians reassign Medicare billing to The Kidney Clinic, which bills Medicare for the services they deliver. Of these, 1 practice at this address and 3 within 10 miles. They are listed nearest first.

Clinicians, nearest first (3)

Shamsul Alam, M.D.
Nephrology
NPI 1912953373
2618 SE J ST SUITE # 2 & 4
Bentonville, AR 72712
(479) 271-9393
✔ PECOS✔ Accepts MedicareSame address
Valerie Bedwell
Nurse Practitioner
NPI 1013394287
2900 MEDICAL CENTER PKWY STE 240B
Bentonville, AR 72712
(479) 553-2200
✔ PECOS✔ Accepts Medicare0.5 mi
Kristine Rowland, APRN
Nurse Practitioner
NPI 1326574625
2618 SE J ST
Bentonville, AR 72712
(479) 271-9393
✔ PECOS0.5 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Shamsul Alam MD PA's NPI number?

The NPI number for Shamsul Alam MD PA is 1639487564. It was assigned to this organization in the NPPES registry on September 14, 2010. The provider is doing business as The Kidney Clinic.

Where is Shamsul Alam MD PA located?

Shamsul Alam MD PA is located at 2618 SE J St Suite#4, Bentonville, AR 72712. The listed phone number is (479) 271-9393.

What is Shamsul Alam MD PA's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Nephrology, with taxonomy code 207RN0300X.

Is Shamsul Alam MD PA enrolled in Medicare?

Yes. Shamsul Alam MD PA is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Shamsul Alam MD PA?

According to the CMS Revalidation Reassignment List (October 2026 release), 3 clinicians reassign their Medicare billing to Shamsul Alam MD PA, in Nephrology and Nurse Practitioner. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Of these, 1 practice at this address and 3 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Shamsul Alam MD PA was last updated on March 2, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.