Individual provider Active NPI

Samer Othman Alharthi, M.D.

  • Vascular Surgery Physician
  • Braselton, GA
National Provider Identifier
1093166316
Registry record updated Oct 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
97342 Issued in GA
Practice address
1400 River PL
Braselton, GA 30517-5600
Phone
(770) 848-8000
NPI assigned
Jun 28, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Surgery Physician 2086S0129X 0101271963 VA
Vascular Surgery Physician 2086S0129X 97342 GA Primary

Addresses

Primary practice location

1400 River PL
Braselton, GA 30517-5600

Mailing address

PO Box 742616
Atlanta, GA 30374-2616
Phone (770) 219-8420

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
I20231009002588 GA Practitioner - Vascular Surgery 4385939826 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Vascular Surgery
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northeast Georgia Physicians Group IncGroup PAC ID 6901898386, 884 clinicians

Practice addresses (Care Compare)

1404 River PL
Suite 201
Braselton, GA 30517-5600
Phone (770) 219-4000

Hospital & facility affiliations

  • Northeast Georgia Medical Center, Inc Hospital, Gainesville, GA, CCN 110029
  • NGMC Barrow, LLC Hospital, Winder, GA, CCN 110045
  • Northeast Georgia Medical Center Lumpkin Hospital, Dahlonega, GA, CCN 110237
  • Northeast Georgia Medical Center Habersham Hospital, Demorest, GA, CCN 110041

Merit-based Incentive Payment System (MIPS)

Final score
87.83 of 100Reported as group
Quality
80.36
Promoting interoperability
100
Improvement activities
40
Cost
79.08

Procedures performed for Medicare patients

ProcedureNumber of procedures
Leg revascularization (restoring blood flow)13

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
97342GAMDVascular Surgery Physician
0101271963VAMDVascular Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Northeast Georgia Physicians Group Inc CurrentSince Oct 1, 2023 Accepting new patients

Locations

1400 River Pl
Braselton, GA 30517
Phone (770) 219-6000

1404 River Pl
Ste 201
Braselton, GA 30517
Phone (770) 219-4000

597 S Enota Dr NE
Gainesville, GA 30501
Phone (770) 219-8275

Organizations & group practices 1

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

Hospital & facility affiliations 4

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": "1467072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696204800000",
    "number": "1093166316",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 742616",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303742616",
            "telephone_number": "770-219-8420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 RIVER PL",
            "city": "BRASELTON",
            "state": "GA",
            "postal_code": "305175600",
            "telephone_number": "770-848-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALHARTHI",
        "first_name": "SAMER",
        "middle_name": "OTHMAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-06-28",
        "last_updated": "2023-10-02",
        "certification_date": "2023-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "VA",
            "license": "0101271963",
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "GA",
            "license": "97342",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Braselton, GA

Sources for this page

Verify at the official NPI Registry.