Individual provider Active NPI

Belkis Pimentel, MD

  • Family Medicine Physician
  • Jonesboro, GA
National Provider Identifier
1093763708
Registry record updated Jan 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
43110 Issued in GA
Practice address
2400 Mount Zion Pkwy
Kaiser Permanente Southwood Medical Office
Jonesboro, GA 30236-2500
Phone
(770) 603-3632
NPI assigned
May 5, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 43110 GA Primary

Addresses

Primary practice location

2400 Mount Zion Pkwy
Kaiser Permanente Southwood Medical Office
Jonesboro, GA 30236-2500

Mailing address

3495 Piedmont Rd NE
Nine Piedmont Center
Atlanta, GA 30305-1717
Phone (404) 364-7000

Other identifiers 1

IdentifierTypeStateIssuer
000809828RMedicaidGA

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepiceast.kp.org:14430/Interconnect-prodgam/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq Health Information Exchange (HIE) Permanente Medical Group

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
I20091104000055 GA Practitioner - Family Practice 9931133493 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Southeast Permanente Medical GroupGroup PAC ID 6204829013, 823 clinicians

Practice addresses (Care Compare)

101 Banks Sta
Fayetteville, GA 30214-7507
Phone (404) 379-6148

1125 Town Ctr Village Dr
McDonough, GA 30253-5970
Phone (678) 583-6610

1175 Cascade Pkwy SW
Atlanta, GA 30311-3090
Phone (404) 505-4012

1435 Broadmoor Blvd
Buford, GA 30518-5408
Phone (770) 480-7506

1478 Dogwood Dr SE
Conyers, GA 30013-5088
Phone (404) 364-7285

1745 Peachtree St NE
Suite U
Atlanta, GA 30309-2479
Phone (404) 379-1105

20 Glenlake Pkwy
Atlanta, GA 30328-3473
Phone (770) 677-6043

200 Crescent Ctr Pkwy
Tucker, GA 30084-7047
Phone (404) 365-0966

205 Newnan Crossing Byp
Newnan, GA 30265-1063
Phone (404) 379-6148

2240 Fountain Dr
Snellville, GA 30078-2919
Phone (404) 379-1105

2400 Mount Zion Pkwy
Jonesboro, GA 30236-2500
Phone (770) 603-3685

2470 Mount Zion Pkwy
BLDG 200
Jonesboro, GA 30236-2500
Phone (770) 527-9031

2525 Cumberland Pkwy SE
Atlanta, GA 30339-3915
Phone (770) 431-4235

3495 Piedmont Rd NE
Atlanta, GA 30305-1729
Phone (404) 364-7206

3550 Preston Ridge Rd
Alpharetta, GA 30005-3821
Phone (770) 663-3395

3640 Tramore Pointe Pkwy
Austell, GA 30106-6825
Phone (404) 379-1105

3650 Steve Reynolds Blvd
Duluth, GA 30096-4506
Phone (770) 931-6026

5440 Hillandale Dr
Lithonia, GA 30058-4865
Phone (770) 322-3238

684 Sixes Rd
Suite 275
Holly Springs, GA 30115-8723
Phone (404) 379-1105

6875 Douglas Blvd
Suite a
Douglasville, GA 30135-7155
Phone (404) 379-6148

750 Townpark LN NW
Kennesaw, GA 30144-5579
Phone (770) 514-5405

8011 Mall Pkwy
Lithonia, GA 30038-2543
Phone (770) 527-9031

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
The Southeast Permanente Medical Group Family Medicine Current Accepting new patients
Atlanta Obstetrics and Family Care, P.C. PastSince Aug 13, 2002 Accepting new patients

Locations

3495 Piedmont Rd NE
Bldg 9
Atlanta, GA 30305
Phone (404) 364-7000

2400 Mount Zion Pkwy
Ofc
Jonesboro, GA 30236
Phone (770) 603-3614

2400 Mount Zion Pkwy
Jonesboro, GA 30236
Phone (770) 603-3649

203 Newnan Crossing Byp
Newnan, GA 30265
Phone (770) 304-4400

1100 Lake Hearn Dr
Ste 250
Sandy Springs, GA 30342
Phone (404) 845-4500

1100 Lake Hearn Dr
Sandy Springs, GA 30342
Phone (404) 255-5512

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1146787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642032000000",
    "number": "1093763708",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3495 PIEDMONT RD NE",
            "address_2": "NINE PIEDMONT CENTER",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303051717",
            "telephone_number": "404-364-7000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2400 MOUNT ZION PKWY",
            "address_2": "KAISER PERMANENTE SOUTHWOOD MEDICAL OFFICE",
            "city": "JONESBORO",
            "state": "GA",
            "postal_code": "302362500",
            "telephone_number": "770-603-3632"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PIMENTEL",
        "first_name": "BELKIS",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-05",
        "last_updated": "2022-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "43110",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000809828R",
            "state": "GA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepiceast.kp.org:14430/Interconnect-prodgam/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "3495 Piedmont Rd NE",
            "city": "Atlanta",
            "state": "GA",
            "country_code": "US",
            "postal_code": "303051717",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Jonesboro, GA

Sources for this page

Verify at the official NPI Registry.