Xavier Ampuero Duralde, MD

Primary specialty

Sports Medicine (Orthopaedic Surgery) PhysicianTaxonomy code 207XX0005X

License

036722 Issued in GA

Practice address

2045 Peachtree Rd NE
Suite 700
Atlanta, GA 30309-1414

Phone

(404) 355-0743

Fax

(404) 603-9887

NPI assigned

Aug 10, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Jul 1, 2014 through Jul 1, 2028

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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

• Peachtree Orthoapedic Clinic, P.a.

  • Pharmacy
  • College Park, GA
  • NPI 1245686716
  NPD (past)
• Peachtree Orthoapedic Clinic, P.a.

  • Pharmacy
  • Cumming, GA
  • NPI 1982464079
  NPD (past)
• Peachtree Orthopaedic Clinic

  • Durable Medical Equipment & Medical Supplies
  • Alpharetta, GA
  • NPI 1588802474
  NPD (past)
• Peachtree Orthopaedic Clinic

  • Durable Medical Equipment & Medical Supplies
  • Duluth, GA
  • NPI 1811135916
  NPD (past)
• Peachtree Orthopaedic Clinic P.a.

  dba Peachtree Orthopaedic Physical Therapy

  • Physical Therapist
  • Atlanta, GA
  • NPI 1306022264
  NPD (past)
• Peachtree Orthopaedic Clinic, P.a.

  • Durable Medical Equipment & Medical Supplies
  • Atlanta, GA
  • NPI 1235678483
  NPD (past)
• Peachtree Orthopaedic Clinic, P.a.

  dba Peachtree Orthopedics

  • Durable Medical Equipment & Medical Supplies
  • Braselton, GA
  • NPI 1245085885
  NPD (past)
• Peachtree Orthopaedic Clinic, P.a..

  dba Peachtree Orthopedics

  • Durable Medical Equipment & Medical Supplies
  • Atlanta, GA
  • NPI 1700460326
  NPD (past)
• Peachtree Orthopaedic Clinic, PA

  • Pharmacy
  • College Park, GA
  • NPI 1205266004
  NPD (past)
• Peachtree Orthopaedic Clinic, PA

  • Durable Medical Equipment & Medical Supplies
  • Woodstock, GA
  • NPI 1215327663
  NPD (past)
• Peachtree Orthopaedic Clinic, PA

  dba Peachtree Orthopedics

  • Durable Medical Equipment & Medical Supplies
  • Dawsonville, GA
  • NPI 1255107181
  NPD (past)
• Peachtree Orthopaedic Clinic, PC

  • Pharmacy
  • Atlanta, GA
  • NPI 1114357910
  NPD (past)

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

{
    "created_epoch": "1123632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1266969600000",
    "number": "1114929189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2001 PEACHTREE RD NE",
            "address_2": "SUITE 705",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303091476",
            "telephone_number": "404-355-0743",
            "fax_number": "404-355-2136"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2045 PEACHTREE RD NE",
            "address_2": "SUITE 700",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303091414",
            "telephone_number": "404-355-0743",
            "fax_number": "404-603-9887"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DURALDE",
        "first_name": "XAVIER",
        "middle_name": "AMPUERO",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-10",
        "last_updated": "2010-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "GA",
            "license": "036722",
            "primary": false
        },
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "GA",
            "license": "036722",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00544585A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Dupuis, MD
• Mark H Dupuis, MD
• Crystal Michelle Duque, RDN
• Anissa Ahuja Durairaj, M.D.
• Rodrigo A Duralde, M.D.
• Anthony Duran
• Barbara Duran
• Marc Anthony Duran, M.D.
• Kelly A Durand, PAAA
• Jessica Steinbook Durando, LCSW

• Sports Medicine (Orthopaedic Surgery) Physician in Atlanta, GA
• Providers in Atlanta, GA by specialty
• Sports Medicine (Orthopaedic Surgery) Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2010; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.