Michael Angel Dicristina, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

022223 Issued in GA

Practice address

33 Upper Riverdale Rd SW
Suite 21
Riverdale, GA 30274-2626

Phone

(770) 968-7933

Fax

(770) 968-6521

NPI assigned

Jun 23, 2005

Reactivated

Apr 6, 2006

Last updated

Jun 8, 2015By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Southern Regional Physicians Management Group, LLC

  • Surgery Physician
  • Riverdale, GA
  • NPI 1043677271
  Medicare reassignment NPD
• Alignmed Partners, PC

  dba GPS Physician Group PC

  • Geriatric Medicine (Internal Medicine) Physician
  • Gardendale, AL
  • NPI 1881109452

  GA

  Medicare reassignment NPD
• Medical Director Services PC

  • Geriatric Medicine (Internal Medicine) Physician
  • Princess Anne, MD
  • NPI 1871955807

  GA

  Medicare reassignment NPD
• South Atlanta Primary Care PC

  • Legal Medicine
  • Jonesboro, GA
  • NPI 1710183454
  Authorized official Same address or phone
• Family Practice Associates of Atlanta

  dba Occupational Medicine Associates

  • Family Medicine Physician
  • Atlanta, GA
  • NPI 1407905540
  NPD (past)
• Fulton Center for Rehabilitation LLC

  • Skilled Nursing Facility
  • Atlanta, GA
  • NPI 1629545975
  NPD (past)

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

{
    "created_epoch": "1119484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1433721600000",
    "number": "1144226135",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33 UPPER RIVERDALE RD SW",
            "address_2": "SUITE #21",
            "city": "RIVERDALE",
            "state": "GA",
            "postal_code": "302742626",
            "telephone_number": "770-968-7933",
            "fax_number": "770-968-6521"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33 UPPER RIVERDALE RD SW",
            "address_2": "SUITE 21",
            "city": "RIVERDALE",
            "state": "GA",
            "postal_code": "302742626",
            "telephone_number": "770-968-7933",
            "fax_number": "770-968-6521"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DICRISTINA",
        "first_name": "MICHAEL",
        "middle_name": "ANGEL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-06-23",
        "last_updated": "2015-06-08",
        "deactivation_date": "2006-03-16",
        "reactivation_date": "2006-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "022223",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000221328E",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Diagnostics Imaging Services (Omi Diagnostics)
• Diagnostics Imaging Services (Omi Diagnostics)
• Lee A Diamond, M.D.
• Eloy Edilberto Diaz Sr., M.D.
• Terry Dickerson, D.P.M.
• Dignity Hospice and Healthcare LLC
• Divine Healing Healthcare & Durable Medical Equipment LLC
• Divine Private Home Care Provider
• Divine Source Healthcare Systems, Inc
• Divine Trinity Mobile Lab & CPR Services, LLC

• Internal Medicine Physician in Riverdale, GA
• Providers in Riverdale, GA by specialty
• Internal Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2015; 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.

Verify at the official NPI Registry.