Individual provider Active NPI

Attiyya Chisolm, MD

  • Student in an Organized Health Care Education/Training Program
  • Miami, FL
National Provider Identifier
1407650229
Registry record updated Apr 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
1010 SW 2ND Ave Unit 902
Miami, FL 33130-4456
Phone
(301) 974-1931
NPI assigned
Apr 2, 2025
Sex
Unspecified or another gender identity
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

1010 SW 2ND Ave Unit 902
Miami, FL 33130-4456

Mailing address

1010 SW 2ND Ave Unit 902
Miami, FL 33130-4456

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
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

Enrollment IDStateProvider typePAC IDDetails
I20250628000114 LA Order and Referring Only - Obstetrics/GynecologyPractitioner - Obstetrics/Gynecology 2961915400

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

NPI Registry JSON

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

{
    "created_epoch": "1743552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743552000000",
    "number": "1407650229",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1010 SW 2ND AVE UNIT 902",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331304456"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1010 SW 2ND AVE UNIT 902",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331304456",
            "telephone_number": "301-974-1931"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHISOLM",
        "first_name": "ATTIYYA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "X",
        "enumeration_date": "2025-04-02",
        "last_updated": "2025-04-02",
        "certification_date": "2025-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

Verify at the official NPI Registry.