Jose Fernando Aristizabal, MD
Individual provider Active NPI Pulmonary Disease Physician · Decatur, GA
NPI 1053385930 · NPPES record last updated Jan 25, 2010
Key facts
- NPI
- 1053385930
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pulmonary Disease Physician 207RP1001X
- License
- 051206 (GA)
- Practice address
- 2665 N Decatur Rd
Suite 430
Decatur, GA 30033-6149 - Phone
- (404) 294-4018
- Fax
- (404) 294-9161
- NPI assigned
- Feb 15, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 10
Hospital & facility affiliations 5
Medicare Care Compare profile
- Specialty
- Pulmonary Disease
- Education
- Other, 1987
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- The Emory Clinic Inc
Practice addresses (Care Compare)
1365 Clifton Rd NE
Atlanta, GA 30322-1013
Phone (404) 778-7525
Hospital & facility affiliations
- Northside Hospital Forsyth
- Emory Johns Creek Hospital
- Northside Hospital
- Northside Hospital Duluth
- Emory University Hospital Midtown
Merit-based Incentive Payment System (MIPS)
- Final score
- 74.67 of 100
- Quality
- 68.5
- Improvement activities
- 40
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in GA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20090720000440 | GA | Practitioner - Pulmonary Disease |
7416998463 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 21054 | AL | MD | Pharmacist |
| 051206 | GA | MD | Critical Care Medicine (Internal Medicine) Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Northside Primary Care Professional Services,LLC | Current | Accepting new patients |
Locations
1490 Milstead Rd NE
#A
Conyers, GA 30012
Phone (770) 922-2217
2665 N Decatur Rd
Ste 430
Decatur, GA 30033
Phone (404) 294-4018
1285 Upper Hembree Rd
Ste 205
Roswell, GA 30076
Phone (770) 521-1587
1000 Johnson Ferry Rd
Sandy Springs, GA 30342
Phone (404) 851-8737
3350 Paddocks Pkwy
Suwanee, GA 30024
Phone (678) 474-9633
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pulmonary Disease Physician | 207RP1001X | 051206 | GA | Yes |
| Critical Care Medicine (Internal Medicine) Physician | 207RC0200X | 051206 | GA |
Addresses
Primary practice location
2665 N Decatur Rd
Suite 430
Decatur, GA 30033-6149
Mailing address
2665 N Decatur Rd
Suite 430
Decatur, GA 30033-6149
Phone (404) 294-4018
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053385930 | Other | GA | NPI |
Other providers in Decatur, GA
- Shantrice Appleby
- Isaiah Ares-Christian
- John Curtis Arey
- Argon Imaging Center
- Allie Argue
- Arjun Patel DMD2, LLC
- Tequella Shaunta Arkadie
- Jerome Michael Armand
- Vanessa Armand
- Brenda Denise Armando
All providers in Decatur, GA · Pulmonary Disease Physician in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 25, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.