Active NPI
David L. Perlow, M.D.
- Urology Physician
- Marietta, GA
National Provider Identifier
1275539470
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Urology Physician
- License
- 25014
- Practice address
- 2520 Windy Hill Rd SE
Ste 305
Marietta, GA 30067-8653 - Phone
- (770) 951-0866
- Fax
- (770) 933-0209
- NPI assigned
- Jun 22, 2005
- Reactivated
- Mar 22, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | 025014 | GA | |
| Urology Physician | 208800000X | 25014 | GA | Primary |
Addresses
Primary practice location
2520 Windy Hill Rd SE
Ste 305
Marietta, GA 30067-8653
Mailing address
2520 Windy Hill Rd SE
Ste 305
Marietta, GA 30067-8653
Phone (770) 951-0866
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 340002346 | Other | GA | MEDICARE RR |
| 7280346 | Other | GA | AETNA |
| 00266417A | Medicaid | GA |
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
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20040116000103 | GA | Practitioner - Urology | 6305747148 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 25014 | GA | MD | Urology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1119398400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1523232000000",
"number": "1275539470",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2520 WINDY HILL RD SE",
"address_2": "STE 305",
"city": "MARIETTA",
"state": "GA",
"postal_code": "300678653",
"telephone_number": "770-951-0866",
"fax_number": "770-933-0209"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2520 WINDY HILL RD SE",
"address_2": "STE 305",
"city": "MARIETTA",
"state": "GA",
"postal_code": "300678653",
"telephone_number": "770-951-0866",
"fax_number": "770-933-0209"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PERLOW",
"first_name": "DAVID",
"middle_name": "L.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-06-22",
"last_updated": "2018-04-09",
"deactivation_date": "2006-03-15",
"reactivation_date": "2006-03-22",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "GA",
"license": "025014",
"primary": false
},
{
"code": "208800000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Urology",
"state": "GA",
"license": "25014",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE RR",
"identifier": "340002346",
"state": "GA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "7280346",
"state": "GA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00266417A",
"state": "GA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Marietta, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2018; 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.