Alaa Mohammedsadik Aljiffry, MBBS

Individual provider Active NPI Pediatrics Physician · Atlanta, GA

NPI 1508024696 · NPPES record last updated Jan 21, 2021

Key facts

NPI
1508024696
Entity type
Individual (NPI type 1)
Primary specialty
Pediatrics Physician 208000000X
License
55907 (WI)
Practice address
1405 Clifton Rd NE
Atlanta, GA 30322-4874
Phone
(404) 256-2593
NPI assigned
May 27, 2008
Sex
Female
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare Care Compare profile

Specialty
Pediatric Medicine
Education
Other, 1999
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

PO Box
Atlanta, GA 30374

Medicare participation

Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20171025001165 GA Practitioner - Pediatric Medicine 9931378957 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Childrens Healthcare of Atlanta Cardiology Inc Current
since Jul 20, 2017
Accepting new patients

Locations

60 Executive Park South NE
Atlanta, GA 30329

2835 Brandywine Rd
Ste 400
Atlanta, GA 30341

2835 Brandywine Rd
Ste 300
Atlanta, GA 30341
Phone (770) 488-9202

1405 Clifton Rd NE
Atlanta, GA 30322
Phone (404) 785-1112

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 55907 WI Yes

Addresses

Primary practice location

1405 Clifton Rd NE
Atlanta, GA 30322-4874

Mailing address

2835 Brandywine Rd Ste 300
Atlanta, GA 30341-5540
Phone (404) 256-2593

Electronic endpoints

TypeEndpointUseAffiliation
Direct Messaging Address sibley@choa.gadirect.com Health Information Exchange (HIE) Children's Healthcare of Atlanta

Other providers in Atlanta, GA

All providers in Atlanta, GA · Pediatrics Physician in Georgia

Sources for this page

Verify at the official NPI Registry.