Anastacia Abdalla, MD
Individual provider Active NPI Pediatrics Physician · Atlanta, GA
NPI 1114287190 · NPPES record last updated Jun 6, 2022
Key facts
- NPI
- 1114287190
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pediatrics Physician 208000000X
- License
- 74263 (GA)
- Practice address
- 1001 Johnson Fy Rd NE
Atlanta, GA 30342-1605 - Phone
- (404) 785-4826
- Fax
- (404) 785-4820
- NPI assigned
- May 23, 2012
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in GA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20120725001118 | GA | Order and Referring Only - Pediatric Medicine |
6507022175 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 74263 | GA | MD | Pediatrics Physician |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 74263 | GA | Yes |
Addresses
Primary practice location
1001 Johnson Fy Rd NE
Atlanta, GA 30342-1605
Mailing address
1001 Johnson Fy Rd NE
Atlanta, GA 30342-1605
Phone (404) 785-4826
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | choa@choa.gadirect.net |
Other providers in Atlanta, GA
- Abc Healthcare of America, LLC.
- Abc Hearing Professionals LLC.
- Abc Midwifery Clinic LLC
- Anna C Abdala
- Awab Ali Mohammadalkhair Abdalhai
- Eddie K. Abdalla
- Omar Abdalla
- Shahd Mohamed Abdalla
- Calvin A Abdallah
- Wassim Abdallah
All providers in Atlanta, GA · Pediatrics Physician in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 6, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.