Individual provider Active NPI

Reneeta Basu, D.O.

  • Family Medicine Physician
  • Lilburn, GA
National Provider Identifier
1003235417
Registry record updated Dec 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
85232 Issued in GA
Practice address
615 Beaver Ruin Rd NW
Lilburn, GA 30047-3401
Phone
(770) 935-8616
NPI assigned
Apr 14, 2014
Last updated
Dec 3, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 3, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X OT015694 PA
Family Medicine Physician 207Q00000X OS16141 FL
Family Medicine Physician 207Q00000X 85232 GA Primary

Addresses

Primary practice location

615 Beaver Ruin Rd NW
Lilburn, GA 30047-3401

Mailing address

1365 Clifton Rd NE
Atlanta, GA 30322-1013

Other practice location 1

2007 Palm Beach Lakes Blvd
West Palm Beach, FL 33409
Phone (561) 420-8555

Other practice location 2

1500 Fifth Ave
McKeesport, PA 15132-2422
Phone (412) 664-2167

Other practice location 3

1500 Fifth Ave
McKeesport, PA 15132-2422
Phone (412) 664-2167

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20200420003422 GA Practitioner - Family Practice 4688908320 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Philadelphia College of Osteopathic Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Emory Specialty Associates, LLCGroup PAC ID 3476559782, 706 clinicians
Esop Rehabilitation LLCGroup PAC ID 9739305749, shared by 9 NPIs, 224 clinicians

Practice addresses (Care Compare)

1821 Clifton Rd NE
Atlanta, GA 30329-4021
Phone (404) 728-6812

875 Flat Shoals Rd SE
Conyers, GA 30094-6640
Phone (770) 785-7669

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94.51 of 100Reported as apm
Quality
80.61
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
OS16141FLMDFamily Medicine Physician
85232GAMDFamily Medicine Physician
OT015694PAMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
The Emory Clinic Inc Single Specialty CurrentSince Jun 23, 2020 Accepting new patients
Emory Specialty Associates, LLC Single Specialty CurrentSince Aug 26, 2022 Accepting new patients
Emory Health Care Past Accepting new patients

Locations

1365 Clifton Rd NE
Atlanta, GA 30322
Phone (404) 778-7525

1821 Clifton Rd NE
Atlanta, GA 30329
Phone (404) 728-6812

2201 Henderson Mill Rd NE
Ste 160
Atlanta, GA 30345
Phone (404) 251-2193

Networks

  • AL HMO D-SNP
  • devoted network organization-14bfd35d-d818-4696-813b-340339e464ef
  • AL HMO
  • devoted network organization-25ba88d3-d0a6-4213-84f1-eef6f2b59f68
  • devoted network organization-84bf27aa-506a-49c4-8818-702cf5e8efb3
  • devoted network organization-d5084670-562f-408b-b100-22a1a4ef4d82
  • devoted network organization-0f7f8d4f-1035-4992-8c02-dc86d12e700e

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/ACIFBA
  • Direct secure messaging: rbasu20127@direct.emory.org

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1397433600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764720000000",
    "number": "1003235417",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1365 CLIFTON RD NE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303221013"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 BEAVER RUIN RD NW",
            "city": "LILBURN",
            "state": "GA",
            "postal_code": "300473401",
            "telephone_number": "770-935-8616"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2007 Palm Beach Lakes Blvd",
            "address_purpose": "LOCATION",
            "city": "West Palm Beach",
            "state": "FL",
            "postal_code": "33409",
            "country_code": "US",
            "telephone_number": "561-420-8555",
            "fax_number": "561-420-8550",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1500 Fifth Ave",
            "address_purpose": "LOCATION",
            "city": "McKeesport",
            "state": "PA",
            "postal_code": "151322422",
            "country_code": "US",
            "telephone_number": "412-664-2167",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1500 Fifth Ave",
            "address_purpose": "LOCATION",
            "city": "McKeesport",
            "state": "PA",
            "postal_code": "151322422",
            "country_code": "US",
            "telephone_number": "412-664-2167",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BASU",
        "first_name": "RENEETA",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-04-14",
        "last_updated": "2025-12-03",
        "certification_date": "2025-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "PA",
            "license": "OT015694",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "OS16141",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "85232",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lilburn, GA

Sources for this page

Verify at the official NPI Registry.