Individual provider Active NPI

Enas Basha, NP

  • Acute Care Nurse Practitioner
  • Conyers, GA
National Provider Identifier
1104328095
Registry record updated Feb 19, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
217282 Issued in GA
Practice address
1412 Milstead Ave NE
Conyers, GA 30012-3877
Phone
(404) 605-2800
NPI assigned
Mar 6, 2018
Last updated
Feb 19, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 19, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 217282 GA Primary

Addresses

Primary practice location

1412 Milstead Ave NE
Conyers, GA 30012-3877

Mailing address

1371 Sonoma Dr
Lawrenceville, GA 30045-7833
Phone (404) 252-0256

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
I20180711001864 GA Practitioner - Nephrology 2264788967 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nephrology
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Piedmont Cardiology of Atlanta, LLCGroup PAC ID 0345321691, 478 clinicians

Practice addresses (Care Compare)

1412 Milstead Ave NE
Conyers, GA 30012-3877
Phone (770) 918-3000

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
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
217282GAMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Piedmont Cardiology of Atlanta, LLC CurrentSince Feb 28, 2020 Accepting new patients
North Atlanta Kidney Specialists CurrentSince Apr 17, 2018 Accepting new patients

Locations

1412 Milstead Ave NE
Conyers, GA 30012
Phone (770) 918-3000

1000 Medical Center Blvd
Lawrenceville, GA 30046
Phone (678) 312-3356

980 Johnson Fy Rd NE
Ste 420
Sandy Springs, GA 30342
Phone (404) 252-0256

Interoperability endpoints

  • FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.441.396886

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.

NPI Registry JSON

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

{
    "created_epoch": "1520294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582070400000",
    "number": "1104328095",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1371 SONOMA DR",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300457833",
            "telephone_number": "404-252-0256"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1412 MILSTEAD AVE NE",
            "city": "CONYERS",
            "state": "GA",
            "postal_code": "300123877",
            "telephone_number": "404-605-2800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BASHA",
        "first_name": "ENAS",
        "name_prefix": "Mrs.",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-03-06",
        "last_updated": "2020-02-19",
        "certification_date": "2020-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "GA",
            "license": "217282",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Conyers, GA

Sources for this page

Verify at the official NPI Registry.