Individual provider Active NPI

Mariam Darbaidze, MD

  • Internal Medicine Physician
  • Easton, PA
National Provider Identifier
1487543245
Registry record updated Jun 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MT235611 Issued in PA
Practice address
400 S Greenwood Ave
Easton, PA 18045-3776
Phone
(484) 503-3073
NPI assigned
Jun 28, 2025
Last updated
Jun 28, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 28, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MT235611 PA Primary

Addresses

Primary practice location

400 S Greenwood Ave
Easton, PA 18045-3776

Mailing address

400 S Greenwood Ave
Easton, PA 18045-3776

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20250710004214 PA Order and Referring Only - Internal MedicinePractitioner - Internal Medicine 6507371408

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MT235611PAMDInternal Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1751068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751068800000",
    "number": "1487543245",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 S GREENWOOD AVE",
            "city": "EASTON",
            "state": "PA",
            "postal_code": "180453776"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 S GREENWOOD AVE",
            "city": "EASTON",
            "state": "PA",
            "postal_code": "180453776",
            "telephone_number": "484-503-3073"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DARBAIDZE",
        "first_name": "MARIAM",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-06-28",
        "last_updated": "2025-06-28",
        "certification_date": "2025-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MT235611",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Easton, PA

Sources for this page

Verify at the official NPI Registry.