Individual provider Active NPI

Allan Antonio Dias, M.D.

  • Pediatric Pulmonology Physician
  • Atlanta, GA
National Provider Identifier
1639355142
Registry record updated Mar 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Pulmonology PhysicianTaxonomy code 2080P0214X
License
65759 Issued in GA
Practice address
859 Mount Vernon Hwy NE Ste 300
Atlanta, GA 30328-4255
Phone
(404) 785-0588
NPI assigned
Jan 15, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 23, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X
Pediatric Pulmonology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2080P0214X 65759 GA Primary

Addresses

Primary practice location

859 Mount Vernon Hwy NE Ste 300
Atlanta, GA 30328-4255

Mailing address

2392 Henderson Pines CT
Tucker, GA 30084-3406
Phone (631) 839-7415

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20171007000061 GA Order and Referring Only - Pediatric MedicinePractitioner - Pediatric Medicine 9436424025

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
65759GAMDPediatric Pulmonology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Scottish Rite Children'S Medical Center Single Specialty Past Accepting new patients
Arthur M. Blank Hospital, Inc. Past Accepting new patients
Scottish Rite Childrens Medical Ctr Past Accepting new patients
Choa Multispecialty, LLC Single Specialty PastSince Mar 26, 2023 Accepting new patients
Egleston Children'S Hospital at Emory University, Inc. Single Specialty Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: adias44961@choa.gadirect.net

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1200355200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679529600000",
    "number": "1639355142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2392 HENDERSON PINES CT",
            "city": "TUCKER",
            "state": "GA",
            "postal_code": "300843406",
            "telephone_number": "631-839-7415"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "859 MOUNT VERNON HWY NE STE 300",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303284255",
            "telephone_number": "404-785-0588"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIAS",
        "first_name": "ALLAN",
        "middle_name": "ANTONIO",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-01-15",
        "last_updated": "2023-03-23",
        "certification_date": "2023-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2080P0214X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics, Pediatric Pulmonology",
            "state": "GA",
            "license": "65759",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.