MAIN STREET PEDIATRICS PC
NPI 1619155306
Pediatrics in Alpharetta, GA
NPI Status: Active since February 05, 2008
Contact Information
401 S MAIN ST
SUITE C5
ALPHARETTA, GA
ZIP 30009
Phone: (678) 205-2437
Fax: (678) 205-2439
- Organization
- Pediatrics
- CLIA Number: 11D1076787
- CLIA Cert. Type: Physician Office
- CLIA Exp. Date: 11-25-2027
About MAIN STREET PEDIATRICS PC
This page provides the complete NPI Profile along with additional information for Main Street Pediatrics Pc, a pediatrician established in Alpharetta, Georgia operating as a Pediatrics. The healthcare provider is registered in the NPI registry with number 1619155306 assigned on February 2008. The practitioner's primary taxonomy code is 208000000X with license number 047388 (GA). The provider is registered as an organization and their NPI record was last updated 17 years ago. Main Street Pediatrics Pc operates as a Multi-Specialty Group with one or more individual practitioners, who practice different areas of specialization. The provider's is doing business as Main Street Pediatrics Pc. The authorized official of this NPI record is Dr. Maribel Labindalawa Angka Servera Md (Physician)
- NPI
- 1619155306
- Provider Legal Name
- MAIN STREET INTERNAL MEDICINE & PEDIATRICS PC
- Other Organization Name
- MAIN STREET PEDIATRICS PC
- Other Name Type
- Doing Business As (3)
- Entity Type
- Organization
- Location Address
- 401 S MAIN ST SUITE C5 ALPHARETTA, GA 30009
- Location Phone
- (678) 205-2437
- Location Fax
- (678) 205-2439
- Mailing Address
- 401 S MAIN ST SUITE C5 ALPHARETTA, GA 30009
- Mailing Phone
- (678) 205-2437
- Mailing Fax
- (678) 205-2439
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 02-05-2008
- Last Update Date
- 01-22-2009
- Code Navigator
A pediatrician like Main Street Pediatrics Pc is a physician who has completed a pediatric residency and is board-certified or board-eligible in a pediatric specialty. Pediatric care providers are trained to care for newborns, infants, children and adolescents. A pediatrician could perform physical exams, manage vaccinations, monitor development milestones, diagnose illnesses, infections, injuries or other health problems, etc.
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Pediatrics
- Taxonomy Code
- 208000000X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- 047388
- License State
- GA
- Taxonomy Description
- A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 207R00000X | Allopathic & Osteopathic Physicians | Internal Medicine | 047657 (GA) |
Group Taxonomy 193200000X MULTI-SPECIALTY GROUP
This provider is a business group of one or more individual practitioners, who practice with different areas of specialization.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| 000884804C | MEDICAID (05) | GA | |
| 000860054D | MEDICAID (05) | GA |
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 11D1076787
- Facility Type
- Physician Office
- Certificate Effective Date
- November 26, 2025
- Certificate Expiration Date
- November 25, 2027
- Laboratory Director
- MARIBEL L. ANGKA SERVERA MD FAA
- Certificate Type
- Certificate for Provider-Performed Microscopy Procedures (PPMP)
- Certificate Type Description
- This CLIA certificate is issued to Main Street Pediatrics Pc in which a physician, midlevel practitioner or dentist that performs specific microscopy procedures during the course of a patient's visit. A limited list of provider-performed microscopy procedures is included under this certificate type, which are categorized as moderate complexity testing.
Reviews for MAIN STREET PEDIATRICS PC
There are currently no reviews for this provider. Be the first person to share your experience with this provider by filling out our review form. Your insights are appreciated and will help others make informed decisions.
NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1619155306, we treat the final digit (6) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 54. The final step is to find the difference between that total and the next multiple of ten (60 - 54 = 6).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 54 is 60. The difference is the calculated check digit.
Other Providers at the Same Location
The following 13 providers are registered at the same or a nearby location.
ALPHARETTA, GA 30009
ALPHARETTA, GA 30009
ALPHARETTA, GA 30009
ALPHARETTA, GA 30009
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1619155306, enumerated as an "organization" on February 05, 2008.
The provider is located at 401 S MAIN ST SUITE C5 ALPHARETTA, GA 30009 and the phone number is (678) 205-2437.
Pediatrics with taxonomy code 208000000X.
The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.
