Individual provider Active NPI

Kunal Mohan Mathur, MD

  • Internal Medicine Physician
  • Atlanta, GA
National Provider Identifier
1063906428
Registry record updated Nov 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
97417 Issued in GA
Practice address
1000 Johnson Fy Rd NE
Atlanta, GA 30342-1611
Phone
(404) 851-8000
NPI assigned
Jun 19, 2018
Last updated
Nov 6, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2025

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 97417 GA Primary
Internal Medicine Physician 207R00000X 4301504425 MI

Addresses

Primary practice location

1000 Johnson Fy Rd NE
Atlanta, GA 30342-1611

Mailing address

1000 Johnson Ferry Rd
Atlanta, GA 30342-1611

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI, GA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20211005000467 MI Practitioner - Internal Medicine 7517219918 Reassigns benefits to 1 organization
I20240524001898 GA Practitioner - Internal Medicine 7517219918 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Washington University School of Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Atlanta Professional Services LLCGroup PAC ID 0840291944, 423 clinicians

Practice addresses (Care Compare)

1000 Johnson Ferry Rd NE
Atlanta, GA 30342-1606
Phone (404) 851-8000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
97417GAMDInternal Medicine Physician
4301504425MIMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Regents of the University of Michigan Internal Medicine CurrentSince Jun 30, 2021 Accepting new patients
Regents of the University of Michigan Internal Medicine Current Accepting new patients
North Atlanta Professional Services LLC CurrentSince Jul 1, 2024 Accepting new patients
Regents of the University of Michigan CurrentSince Jun 30, 2021 Accepting new patients

Locations

1000 Johnson Ferry Rd
Sandy Springs, GA 30342
Phone (404) 851-8737

1000 Johnson Fy Rd NE
Sandy Springs, GA 30342
Phone (404) 851-1000

1500 E Medical Center Dr
Ann Arbor, MI 48109
Phone (734) 936-4280

3621 S State St
Ann Arbor, MI 48108
Phone (734) 647-5229

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.

Hospital & facility affiliations 1

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": "1529366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762387200000",
    "number": "1063906428",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 JOHNSON FERRY RD",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303421611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 JOHNSON FY RD NE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303421611",
            "telephone_number": "404-851-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATHUR",
        "first_name": "KUNAL",
        "middle_name": "MOHAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-06-19",
        "last_updated": "2025-11-06",
        "certification_date": "2025-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "97417",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301504425",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.