Albert Wildstein, MD

Primary specialty

Vascular Surgery PhysicianTaxonomy code 2086S0129X

License

D31372 Issued in GA

Practice address

2675 N Decatur Rd
Suite 210
Decatur, GA 30033

Phone

(404) 292-5938

Fax

(404) 292-3291

NPI assigned

Mar 14, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1142294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1283385600000",
    "number": "1972571107",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2675 N DECATUR RD",
            "address_2": "SUITE 210",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "30033",
            "telephone_number": "404-292-5938",
            "fax_number": "404-292-3291"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2675 N DECATUR RD",
            "address_2": "SUITE 210",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "30033",
            "telephone_number": "404-292-5938",
            "fax_number": "404-292-3291"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILDSTEIN",
        "first_name": "ALBERT",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-14",
        "last_updated": "2010-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "GA",
            "license": "D31372",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00178329G",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Daniel Kyle Wiesman
• Kayla Wiggins, RN
• William Wilcox
• Richard Edward Wild, M.D.
• Cometa Wilder, LCSW
• Janice Marie Wiley, LCSW
• Stephanie Wiley
• Beth J Wilkening, P.A.-C
• Kayla Wilkins, MSW, ACSW
• Jane Louise Wilkov, MD

• Vascular Surgery Physician in Decatur, GA
• Providers in Decatur, GA by specialty
• Vascular Surgery Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.