Active NPI
Grzegorz Danielczok, MD
- Pediatrics Physician
- Atlanta, GA
National Provider Identifier
1073002333
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 89020
- Practice address
- 1405 Clifton Rd NE
Atlanta, GA 30322-0001 - Phone
- (404) 785-5437
- NPI assigned
- May 2, 2018
- Last updated
- Jan 18, 2022
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 89020 | GA | Primary |
Addresses
Primary practice location
1405 Clifton Rd NE
Atlanta, GA 30322-0001
Mailing address
811 Juniper St NE Apt 1238
Atlanta, GA 30308-1695
Phone (561) 542-6585
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| SOAP URL | https://careepiceast.kp.org:14430/Interconnect-prodgam/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq | Health Information Exchange (HIE) | Permanente Medical Group |
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Emory Medical Care Foundation Inc | Current | Accepting new patients | |
| Emory Medical Care Foundation Inc | Current | Accepting new patients | |
| Emory Medical Care Foundation Inc | Pediatrics | Current | Accepting new patients |
Locations
2201 Henderson Mill Rd NE
Ste 160
Atlanta, GA 30345
Phone (404) 251-2193
80 Jesse Hill Jr Dr SE
Atlanta, GA 30303
Phone (404) 616-4370
Organizations & group practices 3
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.
-
- Internal Medicine Physician
- Atlanta, GA
- NPI 1063452381
-
- Diagnostic Radiology Physician
- Atlanta, GA
- NPI 1225294739
-
- Pediatrics Physician
- Atlanta, GA
- NPI 1730345240
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1525219200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1642464000000",
"number": "1073002333",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "811 JUNIPER ST NE APT 1238",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303081695",
"telephone_number": "561-542-6585"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1405 CLIFTON RD NE",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303220001",
"telephone_number": "404-785-5437"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DANIELCZOK",
"first_name": "GRZEGORZ",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-05-02",
"last_updated": "2022-01-18",
"certification_date": "2021-10-14",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "GA",
"license": "89020",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "SOAP",
"endpointTypeDescription": "SOAP URL",
"endpoint": "https://careepiceast.kp.org:14430/Interconnect-prodgam/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq",
"affiliation": "Y",
"endpointDescription": "Carequality",
"affiliationName": "Permanente Medical Group",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "C-CDA",
"address_1": "811 Juniper St NE Apt 1238",
"city": "Atlanta",
"state": "GA",
"country_code": "US",
"postal_code": "303081695",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Atlanta, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.