Diana Fertsch, MD PHD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

D45937 Issued in MD

Practice address

1792 Merritt Blvd
Dundalk Pediatric Associates
Dundalk, MD 21222-2122

Phone

(410) 284-1133

Fax

(410) 284-3371

NPI assigned

Feb 7, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine, Doctor of Philosophy

State licenses

Interoperability endpoints

• Direct secure messaging: dianafertsch@dped.allscriptsdirect.net

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

{
    "created_epoch": "1139270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592524800000",
    "number": "1508839077",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1792 MERRITT BLVD",
            "address_2": "DUNDALK PEDIATRIC ASSOCIATES",
            "city": "DUNDALK",
            "state": "MD",
            "postal_code": "21222",
            "telephone_number": "410-284-1133",
            "fax_number": "410-284-3371"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1792 MERRITT BLVD",
            "address_2": "DUNDALK PEDIATRIC ASSOCIATES",
            "city": "DUNDALK",
            "state": "MD",
            "postal_code": "212222122",
            "telephone_number": "410-284-1133",
            "fax_number": "410-284-3371"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FERTSCH",
        "first_name": "DIANA",
        "name_prefix": "Dr.",
        "credential": "MD PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-07",
        "last_updated": "2020-06-19",
        "certification_date": "2020-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MD",
            "license": "D45937",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "147571100",
            "state": "MD"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dianafertsch@dpeds.allscriptsdirect.net",
            "affiliation": "N",
            "endpointDescription": "office",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "other",
            "address_1": "1792 Merritt Blvd",
            "address_2": "Dundalk Pediatric Associates",
            "city": "Dundalk",
            "state": "MD",
            "country_code": "US",
            "postal_code": "212222122",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Pediatrics Physician in Dundalk, MD
• Providers in Dundalk, MD by specialty
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.