Michael Daniel Echemendia, M.D.

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

019880 Issued in GA

Practice address

11975 Morris Rd
Suite 200
Alpharetta, GA 30005-4419

Phone

(770) 751-3600

Fax

(770) 751-3615

NPI assigned

Oct 18, 2005

Last updated

May 12, 2016By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 4

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 Oct 1, 2013 through Oct 1, 2027

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Atlanta Women's Health Group, P.C.

  • Obstetrics & Gynecology Physician
  • Sandy Springs, GA
  • NPI 1013971753
  NPD (past)
• Northside Surgical Professional Services LLC

  • Surgery Physician
  • Atlanta, GA
  • NPI 1356630990
  NPD (past)

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

{
    "created_epoch": "1129593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1463011200000",
    "number": "1255320719",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5780 PEACHTREE DUNWOODY ROAD",
            "address_2": "SUITE 300",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303421513",
            "telephone_number": "404-303-1224",
            "fax_number": "404-303-1325"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11975 MORRIS RD",
            "address_2": "SUITE 200",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "300054419",
            "telephone_number": "770-751-3600",
            "fax_number": "770-751-3615"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ECHEMENDIA",
        "first_name": "MICHAEL",
        "middle_name": "DANIEL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-18",
        "last_updated": "2016-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "GA",
            "license": "019880",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000252535C",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000252535L",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000252535E",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000252535K",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tishana Eason
• Dylan Easterling, DC
• Melissa G Eaton, MD
• Sarah K Eaton, RN
• Sandi Ecclestone, MS, PT
• Chidiebere Peter Echieh
• Echolocation Counseling, LLC
• Susan Eckhart, CCC-SLP
• Lynn Eddy
• Lauren Ashley Wages Edeker, PAC

• Obstetrics & Gynecology Physician in Alpharetta, GA
• Providers in Alpharetta, GA by specialty
• Obstetrics & Gynecology Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2016; 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.