Pooja Niranjan Dave, PH.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

PSY004564 Issued in GA

Practice address

355 Tower Rd NE Ste 203
Marietta, GA 30060-9413

Phone

(470) 267-1580

NPI assigned

Jul 14, 2017

Last updated

Jan 3, 2022By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MA, GA2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Specialty

Clinical Psychologist

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Wellstar Medical Group LLCGroup PAC ID 6709065402, 3,059 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

93.93 of 100Reported as apm

Quality

82.14

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

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.

• Wellstar Medical Group, LLC

  dba WellStar Family Medicine ACW

  • Family Medicine Physician
  • Kennesaw, GA
  • NPI 1558664003

  Single Specialty

  Medicare reassignment Care Compare group NPD
• Cambridge Public Health Commission

  dba Cambridge Health Alliance

  • General Acute Care Hospital
  • Cambridge, MA
  • NPI 1487603585

  Single Specialty

  Medicare reassignment NPD
• Wellstar Medical Group, LLC

  • Multi-Specialty Clinic/Center
  • Marietta, GA
  • NPI 1275992240

  Single Specialty

  NPD
• Cambridge Public Health Commission

  dba Cambridge Health Alliance

  • General Acute Care Hospital
  • Cambridge, MA
  • NPI 1932313228

  Single Specialty

  NPD

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

{
    "created_epoch": "1499990400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641168000000",
    "number": "1033631643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "355 TOWER RD NE",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300609408",
            "telephone_number": "470-267-1580"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "355 TOWER RD NE STE 203",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300609413",
            "telephone_number": "470-267-1580"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVE",
        "first_name": "POOJA",
        "middle_name": "NIRANJAN",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-07-14",
        "last_updated": "2022-01-03",
        "certification_date": "2022-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MA",
            "license": "10758",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "GA",
            "license": "PSY004564",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "IL",
            "license": "071009607",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "pdave434878@directwellstar.org",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "355 Tower Rd NE Ste 203",
            "city": "Marietta",
            "state": "GA",
            "country_code": "US",
            "postal_code": "300609413",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Dasog LLC (Whitlock Avenue Dental)
• Jaydip Datta, MD
• Ajay Davalur, DMD
• Ahmad Davari, DC
• Chirag Niranjan Dave, M.D.
• Katie Marie Davenport, DPT, PT
• David Koentop
• Thomas J David, DDS
• Kristal Sheree Davidson, LPC, NCC
• Melissa M Davidson, PA

• Psychologist in Marietta, GA
• Providers in Marietta, GA by specialty
• Psychologist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.