Individual provider Active NPI

Carlos Maisonet

  • Point of Service
  • Peachtree Corners, GA
National Provider Identifier
1063103323
Registry record updated May 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Point of ServiceTaxonomy code 305S00000X
Practice address
4920 Berkeley Oak Cir
Peachtree Corners, GA 30092-4959
Phone
(770) 900-6249
NPI assigned
May 17, 2023
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 26, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Point of Service 305S00000X Primary

Addresses

Primary practice location

4920 Berkeley Oak Cir
Peachtree Corners, GA 30092-4959

Mailing address

4920 Berkeley Oak Cir
Peachtree Corners, GA 30092-4959
Phone (770) 900-6249

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1684281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685059200000",
    "number": "1063103323",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4920 BERKELEY OAK CIR",
            "city": "PEACHTREE CORNERS",
            "state": "GA",
            "postal_code": "300924959",
            "telephone_number": "770-900-6249"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4920 BERKELEY OAK CIR",
            "city": "PEACHTREE CORNERS",
            "state": "GA",
            "postal_code": "300924959",
            "telephone_number": "770-900-6249"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAISONET",
        "first_name": "CARLOS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-05-17",
        "last_updated": "2023-05-26",
        "certification_date": "2023-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "305S00000X",
            "taxonomy_group": "",
            "desc": "Point of Service",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Peachtree Corners, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.