Individual provider Active NPI

Fred Lester Daniel, MD

  • Otolaryngology/Facial Plastic Surgery Physician
  • Savannah, GA
National Provider Identifier
1013918150
Registry record updated Apr 1, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology/Facial Plastic Surgery PhysicianTaxonomy code 207YX0905X
License
026496 Issued in GA
Practice address
5201 Frederick Street
Savannah, GA 31405-4501
Phone
(912) 351-3030
Fax
(912) 351-3039
NPI assigned
Aug 10, 2005
Last updated
Apr 1, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology/Facial Plastic Surgery Physician 207YX0905X 26496 GA
Otolaryngology/Facial Plastic Surgery Physician 207YX0905X 026496 GA Primary

Addresses

Primary practice location

5201 Frederick Street
Savannah, GA 31405-4501

Mailing address

5201 Frederick Street
Savannah, GA 31405-4501
Phone (912) 351-3030

Other identifiers 1

IdentifierTypeStateIssuer
00291695GMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20101208000450 GA Practitioner - Otolaryngology 8123000171 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
26496GAMDOtolaryngology/Facial Plastic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Privia Medical Group of Georgia LLC CurrentSince Aug 20, 2024 Accepting new patients
Ear, Nose & Throat Associates of Savannah, PC Current Accepting new patients
Ear, Nose & Throat Associates of Savannah, PC CurrentSince Jan 1, 2000 Accepting new patients
Ear, Nose & Throat Associates of Savannah, PC CurrentSince Jan 1, 2000 Accepting new patients
Privia Medical Group of Georgia LLC CurrentSince Aug 20, 2024 Accepting new patients
Audiology and Hearing Aid Services Current Accepting new patients
Savannah Partners, LLC Current Accepting new patients
Ear, Nose & Throat Associates of Savannah, PC Past Accepting new patients

Locations

101 Yorktown Dr
Ste 100
Fayetteville, GA 30214
Phone (770) 460-4285

1000 Towne Center Blvd
Ste 200
Pooler, GA 31322
Phone (912) 330-8075

5201 Frederick St
Savannah, GA 31405

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/8042/brand/1/csg/1/fhir/r4

Organizations & group practices 10

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": "1123632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1270080000000",
    "number": "1013918150",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5201 FREDERICK STREET",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314054501",
            "telephone_number": "912-351-3030",
            "fax_number": "912-351-3039"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5201 FREDERICK STREET",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314054501",
            "telephone_number": "912-351-3030",
            "fax_number": "912-351-3039"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DANIEL",
        "first_name": "FRED",
        "middle_name": "LESTER",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-10",
        "last_updated": "2010-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207YX0905X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Otolaryngology/Facial Plastic Surgery",
            "state": "GA",
            "license": "26496",
            "primary": false
        },
        {
            "code": "207YX0905X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Otolaryngology/Facial Plastic Surgery",
            "state": "GA",
            "license": "026496",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00291695G",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Savannah, GA

Sources for this page

Verify at the official NPI Registry.