Autumn Ivy
NPI 1659638666 · Neurology with Special Qualifications in Child Neurology Physician · Baltimore, MD
Enrolled with Medicare as Practitioner - Pediatric Medicine · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Provider details
- NPI number
- 1659638666
- Entity type
- Individual
- Primary specialty
- Neurology with Special Qualifications in Child Neurology PhysicianAllopathic & Osteopathic Physicians
- Sex
- Female
- Sole proprietor
- No
- License
- A126865 (CA)
Specialties & taxonomies
- Neurology with Special Qualifications in Child Neurology PhysicianPrimary2084N0402XLicense D0101347 (MD)
Allopathic & Osteopathic Physicians
Allopathic & Osteopathic Physicians
Allopathic & Osteopathic Physicians
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
14 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
2 documented practice locations
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Additional practice locations (1)
- 1201 W La Veta AveOrange, CA 92868-4203Phone: (888) 770-2462
Registry dates
- Enumerated
- 2012-04-13
- Last updated
- 2024-08-15
- Certified
- 2024-08-15
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.