Individual provider Active NPI

Abdulsattar Zidan, MD

  • Pediatrics Physician
  • Montgomery, AL
National Provider Identifier
1003072794
Registry record updated May 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
31147 Issued in AL
Practice address
1845 Cherry St
Montgomery, AL 36107-2613
Phone
(334) 420-5001
Fax
(334) 420-0158
NPI assigned
Aug 1, 2008
Last updated
May 22, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 22, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 31147 AL Primary

Addresses

Primary practice location

1845 Cherry St
Montgomery, AL 36107-2613

Mailing address

1020 Southlake CV
Hoover, AL 35244-3282
Phone (304) 840-3001

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20131121000873 AL Practitioner - Pediatric Medicine 6305072372 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Health Services, Inc. CurrentSince Oct 4, 2013 Accepting new patients
Hoover Pediatrics Inc Pediatrics CurrentSince Mar 31, 2024 Accepting new patients
Health Services Inc CurrentSince Oct 4, 2013 Accepting new patients
Health Services Inc Current Accepting new patients

Locations

203 N Taylor St
Autaugaville, AL 36003
Phone (334) 263-2301

107 Medical Center Dr
Clanton, AL 35045
Phone (205) 280-1478

511 E Tuskeena St
Hayneville, AL 36040
Phone (334) 548-2516

Interoperability endpoints

  • Direct secure messaging: abdulsattar.zidan.1@14429.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/14429/brand/5/csg/1/fhir/r4
  • FHIR API: https://fhir4.healow.com/fhir/r4/HEAEDD/Endpoint/HEAEDD

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1217548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716336000000",
    "number": "1003072794",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1020 SOUTHLAKE CV",
            "city": "HOOVER",
            "state": "AL",
            "postal_code": "352443282",
            "telephone_number": "304-840-3001",
            "fax_number": "205-238-5703"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1845 CHERRY ST",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361072613",
            "telephone_number": "334-420-5001",
            "fax_number": "334-420-0158"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZIDAN",
        "first_name": "ABDULSATTAR",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-08-01",
        "last_updated": "2024-05-22",
        "certification_date": "2024-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "AL",
            "license": "31147",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Montgomery, AL

Sources for this page

Verify at the official NPI Registry.