Individual provider Active NPI

Nilusha Hirani

  • Physician Assistant
  • Stone Mountain, GA
National Provider Identifier
1003386814
Registry record updated Mar 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
023056 Issued in NY
Practice address
931 Oakwood Chase Cir
Stone Mountain, GA 30083-5063
Phone
(631) 906-9403
NPI assigned
Dec 5, 2018
Last updated
Mar 22, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 22, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 023056 NY
Physician Assistant 363A00000X 023056 NY Primary

Addresses

Primary practice location

931 Oakwood Chase Cir
Stone Mountain, GA 30083-5063

Mailing address

931 Oakwood Chase Cir
Stone Mountain, GA 30083-5063
Phone (631) 906-9403

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200428000532 NY Practitioner - Physician Assistant 7012347321 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Sarita Khatri MD OB-GYN PC Past Accepting new patients
Paulette a Stewart, MD PC Internal Medicine PastSince Apr 29, 2018 Accepting new patients

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1543968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679443200000",
    "number": "1003386814",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "931 OAKWOOD CHASE CIR",
            "city": "STONE MOUNTAIN",
            "state": "GA",
            "postal_code": "300835063",
            "telephone_number": "631-906-9403"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "931 OAKWOOD CHASE CIR",
            "city": "STONE MOUNTAIN",
            "state": "GA",
            "postal_code": "300835063",
            "telephone_number": "631-906-9403"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HIRANI",
        "first_name": "NILUSHA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-12-05",
        "last_updated": "2023-03-22",
        "certification_date": "2023-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "023056",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "023056",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stone Mountain, GA

Sources for this page

Verify at the official NPI Registry.