MAIN STREET PEDIATRICS PC
NPI 1619155306
Pediatrics in Alpharetta, GA

Q: What is Main Street Internal Medicine & Pediatrics PC's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Active since February 05, 2008CLIA 11D1076787 · Microscopy

401 S MAIN ST, SUITE C5, ALPHARETTA, GA 30009(678) 205-2437(678) 205-2439 Get Directions Write a Review

NPPES record last updated: January 22, 2009. Verified against the NPPES registry weekly; last sync: October 25, 2026.

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About Main Street Pediatrics Pc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MAIN STREET PEDIATRICS PC (NPI 1619155306) is a healthcare organization registered as a pediatrics in Alpharetta, Georgia and active in the NPI registry since February 2008. The organization holds a CLIA Microscopy certificate valid through November 25, 2027 and lists Maribel Labindalawa Angka Servera, Physician, as its authorized official.

NPPES Registry Identity

NPI1619155306

Entity TypeOrganization

Primary Taxonomy208000000X

Legal Business NameMAIN STREET INTERNAL MEDICINE & PEDIATRICS PC

Location Address401 S MAIN ST, SUITE C5Alpharetta, GA 30009-7960

Mailing Address401 S Main St, Suite C5Alpharetta, GA 30009-7960 · (678) 205-2437 · Fax (678) 205-2439

Phone(678) 205-2437

Fax(678) 205-2439

Organization SubpartNo

Authorized OfficialMaribel Labindalawa Angka ServeraPhysician · (678) 205-2437

Enumeration DateFebruary 5, 2008

Last NPPES UpdateJanuary 22, 2009

✔ NPI 1619155306 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians

Taxonomy Code208000000X

License✔ Licensed in GA · 047388

Definition

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.

Also ListedInternal MedicineTaxonomy 207R00000X · License 047657 (GA)

401 S MAIN ST, Alpharetta, GA 30009

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Other Names 1

Doing Business AsMain Street Pediatrics Pc

Other Identifiers 2

Medicaid000884804CGA

Medicaid000860054DGA

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Main Street Pediatrics Pc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Main Street Pediatrics PC, which bills Medicare for the services this clinician delivers.

Clinician (1)

Maribel Angka-Servera, MD

Pediatric Medicine

NPI 1932162989

401 S MAIN ST SUITE C5
Alpharetta, GA 30009

(678) 205-2437

✔ PECOSSame address

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate for Provider-Performed Microscopy Procedures (PPMP) 11D1076787

Main Street Internal Medicine And Pediatrics PC · Alpharetta, GA

Active · expires Nov 25, 2027

CLIA Number11D1076787

Laboratory TypePhysician Office

Certificate Effective DateNovember 26, 2025

Certificate Expiration DateNovember 25, 2027

Laboratory DirectorMaribel L. Angka Servera MD Faa

Laboratory Phone(678) 205-2437

Laboratory LocationMain Street Internal Medicine And Pediatrics PC401 S Main Street Suite C 5, Alpharetta, GA 30009

CLIA data matches this NPI record on: Address Phone

This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Main Street Internal Medicine & Pediatrics PC's NPI number?

The NPI number for Main Street Internal Medicine & Pediatrics PC is 1619155306. It was assigned to this organization in the NPPES registry on February 5, 2008. The provider is doing business as Main Street Pediatrics PC.

Where is Main Street Internal Medicine & Pediatrics PC located?

Main Street Internal Medicine & Pediatrics PC is located at 401 S Main St Suite C5, Alpharetta, GA 30009. The listed phone number is (678) 205-2437.

What is Main Street Internal Medicine & Pediatrics PC's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Is Main Street Internal Medicine & Pediatrics PC enrolled in Medicare?

Yes. Main Street Internal Medicine & Pediatrics PC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Main Street Internal Medicine & Pediatrics PC?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Pediatric Medicine) reassigns their Medicare billing to Main Street Internal Medicine & Pediatrics PC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Main Street Internal Medicine & Pediatrics PC hold a CLIA laboratory certificate?

Yes. A Certificate for Provider-Performed Microscopy Procedures (PPMP) (number 11D1076787) is associated with this NPI, valid through November 25, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Main Street Internal Medicine & Pediatrics PC was last updated on January 22, 2009. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.