Individual provider Active NPI

Maria Fleiderman

  • Pediatrics Physician
  • Atlanta, GA
National Provider Identifier
1932871803
Registry record updated Jun 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
57.255290 Issued in OH
Practice address
720 Westview Dr SW
Atlanta, GA 30310-1458
Phone
(404) 752-1500
NPI assigned
Sep 29, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 57.255290 OH Primary
Student in an Organized Health Care Education/Training Program 390200000X 390200000X GA

Addresses

Primary practice location

720 Westview Dr SW
Atlanta, GA 30310-1458

Mailing address

720 Westview Dr SW
Atlanta, GA 30310-1458

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20230712003554 OH Order and Referring Only - Pediatric MedicinePractitioner - Pediatric Medicine 0345600110

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
390200000XGAMDAthletic Trainer

NPI Registry JSON

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

{
    "created_epoch": "1632873600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687824000000",
    "number": "1932871803",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "720 WESTVIEW DR SW",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303101458"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "720 WESTVIEW DR SW",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303101458",
            "telephone_number": "404-752-1500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLEIDERMAN",
        "first_name": "MARIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-29",
        "last_updated": "2023-06-27",
        "certification_date": "2023-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "OH",
            "license": "57.255290",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "GA",
            "license": "390200000X",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.