Aliya Matthews, DPM

Primary specialty

PodiatristTaxonomy code 213E00000X

License

POD001184 Issued in GA

Practice address

1204 Bentley Estates Dr
Dacula, GA 30019-7786

Phone

(609) 922-1866

NPI assigned

Jul 23, 2008

Last updated

Apr 18, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other names 1

• Aliya Fagan Former name

Medicare fee-for-service enrollment

Enrolled in GA, SC2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Specialty

Podiatry

Education

Temple University School of Medicine, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

The Southeast Permanente Medical GroupGroup PAC ID 6204829013, 823 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

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.

• Divine Podiatry Center LLC

  • Podiatrist
  • Dacula, GA
  • NPI 1528530268
  Medicare reassignment NPD Authorized official
• The Southeast Permanente Medical Group

  • Internal Medicine Physician
  • Atlanta, GA
  • NPI 1245266956

  Podiatrist

  Medicare reassignment Care Compare group NPD
• Special Care Podiatry of Georgia, LLC

  • Podiatrist
  • Byron, GA
  • NPI 1891195962
  Medicare reassignment NPD
• 360Care LLC

  • Dentist
  • Louisville, KY
  • NPI 1417592536

  Podiatrist, SC

  Medicare reassignment NPD
• Divine Podiatry

  • Podiatrist
  • Dacula, GA
  • NPI 1104235613
  Authorized official Same address or phone
• 360Care LLC

  • Audiologist
  • Columbia, SC
  • NPI 1619598281
  NPD
• DRS. Wiener & Daniels DPM.PA

  • Podiatric Clinic/Center
  • Eldersburg, MD
  • NPI 1841418936
  NPD (past)
• Steven Wiener DPM PA

  dba Wiener & Daniels DPM PA.

  • Podiatric Clinic/Center
  • Baltimore, MD
  • NPI 1699952432
  NPD (past)
• Steven Wiener DPM PA

  dba DRS. Wiener & Daniels DPM PA.

  • Podiatric Clinic/Center
  • Dundalk, MD
  • NPI 1740467000
  NPD (past)
• Wiener and Daniels, DPM, PA

  dba Steven Wiener DPM

  • Podiatric Clinic/Center
  • Owings Mills, MD
  • NPI 1518184936

  Podiatrist

  NPD (past)

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

{
    "created_epoch": "1216771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1587168000000",
    "number": "1487819173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1204 BENTLEY ESTATES DR",
            "city": "DACULA",
            "state": "GA",
            "postal_code": "300197786",
            "telephone_number": "609-922-1866"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1204 BENTLEY ESTATES DR",
            "city": "DACULA",
            "state": "GA",
            "postal_code": "300197786",
            "telephone_number": "609-922-1866"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATTHEWS",
        "first_name": "ALIYA",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-23",
        "last_updated": "2020-04-18",
        "certification_date": "2020-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "PA",
            "license": "SC006065",
            "primary": false
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "GA",
            "license": "POD001184",
            "primary": true
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "PA",
            "license": "SC006065",
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "MD",
            "license": "01490",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ALIYA",
            "last_name": "FAGAN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Kayla Marshall, PHARMD
• Kenya Marthone
• Uyen DO Maschek, DMD
• Deena Suzanne Massengale, PHARMD, RPH
• Shawn Mathew, DMD
• Gina M Maxey, M.D.
• Amie Patricia May, NP
• Anke Mbapeh
• James Joseph MC Farland, M.S., M.D.
• Ebonie McAfee, LPC

• Podiatrist in Dacula, GA
• Providers in Dacula, GA by specialty
• Podiatrist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2020; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.