Individual provider Active NPI

Manzoor Sheikh Ali, M.D., PH.D.

  • Internal Medicine Physician
  • Lawrenceville, GA
National Provider Identifier
1093820300
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
050779 Issued in GA
Practice address
2118 Wildcat Cliffs LN
Lawrenceville, GA 30043-2969
Phone
(770) 236-8388
Fax
(770) 236-8388
NPI assigned
Aug 20, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 050779 GA Primary

Addresses

Primary practice location

2118 Wildcat Cliffs LN
Lawrenceville, GA 30043-2969

Mailing address

2118 Wildcat Cliffs LN
Lawrenceville, GA 30043-2969
Phone (770) 236-8388

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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
I20190315000925 AL Practitioner - Emergency Medicine 9133281140

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
050779GAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ecc Hospitalist Services PC Internal Medicine Past Accepting new patients
Mount Lassen Emergency Physicians LLC Past Accepting new patients
Hospital Physician Services - Southeast Professional Corporation Past Accepting new patients

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1156032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1093820300",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2118 WILDCAT CLIFFS LN",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300432969",
            "telephone_number": "770-236-8388",
            "fax_number": "770-236-8388"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2118 WILDCAT CLIFFS LN",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300432969",
            "telephone_number": "770-236-8388",
            "fax_number": "770-236-8388"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALI",
        "first_name": "MANZOOR",
        "middle_name": "SHEIKH",
        "name_prefix": "Dr.",
        "credential": "M.D., PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "050779",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lawrenceville, GA

Sources for this page

Verify at the official NPI Registry.