Daniel B Charek, PH.D.

Primary specialty

Clinical NeuropsychologistTaxonomy code 103G00000X

License

00000 Issued in GA

Practice address

11685 Alpharetta Hwy Ste 170
Roswell, GA 30076

Phone

(770) 663-1100

Fax

(770) 663-1101

NPI assigned

Apr 4, 2018

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Specialty

Clinical Psychologist

Education

Toledo Medical College, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Northside Surgical Professional Services LLCGroup PAC ID 8628253424, 367 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

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 and National Provider Directory roles.

• Northside Surgical Professional Services LLC

  • Surgery Physician
  • Atlanta, GA
  • NPI 1356630990
  Medicare reassignment Care Compare group NPD
• Advanced Joint Surgery Specialists, LLC

  • Orthopaedic Surgery Physician
  • Atlanta, GA
  • NPI 1477929206
  NPD (past)
• Mercy Health Physicians Cincinnati, LLC

  • Family Medicine Physician
  • Blue Ash, OH
  • NPI 1205887023
  NPD (past)

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

{
    "created_epoch": "1522800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614297600000",
    "number": "1861998197",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "607 E CARSON ST APT 5",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152031005",
            "telephone_number": "330-283-6246"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11685 ALPHARETTA HWY STE 170",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "30076",
            "telephone_number": "770-663-1100",
            "fax_number": "770-663-1101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAREK",
        "first_name": "DANIEL",
        "middle_name": "B",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-04-04",
        "last_updated": "2021-02-26",
        "certification_date": "2021-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "GA",
            "license": "00000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "NCOSM@Northside.gwaydirect.com",
            "affiliation": "N",
            "endpointDescription": "Direct Messaging",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Direct Edge",
            "address_1": "11685 Alpharetta Hwy Ste 170",
            "city": "Roswell",
            "state": "GA",
            "country_code": "US",
            "postal_code": "30076",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Angela Yaelim Chang, DMD
• David Chang
• Wei Yen Chang, D.D.S.
• Changing Hope Counseling LLC
• Erica Nicole Chapman, ED.D.
• Rochelle Charles, RBT
• Sumi Chatani, DPT
• Brenda Chau, MA, CCC-SLP
• Mary Frances Chaussinand, CPNP
• Eesa Chavis

• Clinical Neuropsychologist in Roswell, GA
• Providers in Roswell, GA by specialty
• Clinical Neuropsychologist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.