Individual provider Active NPI

Farhana Quasem, MD

  • Internal Medicine Physician
  • Conyers, GA
National Provider Identifier
1093773905
Registry record updated Jun 21, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
044819 Issued in GA
Practice address
2080 Eastside Drive
Suite a
Conyers, GA 30013
Phone
(678) 625-7800
Fax
(678) 625-7888
NPI assigned
May 2, 2006
Last updated
Jun 21, 2010By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 044819 GA Primary

Addresses

Primary practice location

2080 Eastside Drive
Suite a
Conyers, GA 30013

Mailing address

2080 Eastside Drive
Suite a
Conyers, GA 30013
Phone (678) 625-7800

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
I20110314000047 GA Practitioner - Internal Medicine 4789638933 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Eastside Internal Medicine, LLCGroup PAC ID 7618921867, 3 clinicians

Practice addresses (Care Compare)

2080 Eastside Dr
Suite a
Conyers, GA 30013-1953
Phone (678) 625-7800

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
91.62 of 100Reported as apm
Quality
83.25
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Eastside Internal Medicine, LLC CurrentSince Jan 1, 2003 Accepting new patients
Eastside Internal Medicine, LLC Internal Medicine Past Accepting new patients

Locations

2080 Eastside Dr
Ste A
Conyers, GA 30013
Phone (678) 625-7800

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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": "1146528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1277078400000",
    "number": "1093773905",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2080 EASTSIDE DRIVE",
            "address_2": "SUITE A",
            "city": "CONYERS",
            "state": "GA",
            "postal_code": "30013",
            "telephone_number": "678-625-7800",
            "fax_number": "678-625-7888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2080 EASTSIDE DRIVE",
            "address_2": "SUITE A",
            "city": "CONYERS",
            "state": "GA",
            "postal_code": "30013",
            "telephone_number": "678-625-7800",
            "fax_number": "678-625-7888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QUASEM",
        "first_name": "FARHANA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-02",
        "last_updated": "2010-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "044819",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Conyers, GA

Sources for this page

Verify at the official NPI Registry.