NPIMap

Individual provider Active NPI

Nelly Mizrahi, M.D.

  • Family Medicine Physician
  • Duluth, GA
National Provider Identifier
1104927565
Registry record updated Dec 3, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
058545 Issued in GA
Practice address
4855 River Green Pkwy
Suite 700
Duluth, GA 30096-8336
Phone
(770) 622-0880
Fax
(770) 622-9875
NPI assigned
Sep 26, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2010

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 058545 GA Primary

Addresses

Primary practice location

4855 River Green Pkwy
Suite 700
Duluth, GA 30096-8336

Mailing address

4855 River Green Pkwy
Suite 700
Duluth, GA 30096-8336
Phone (770) 622-0880

Other identifiers 2

IdentifierTypeStateIssuer
058545OtherGAGA LICENSE
170546490AMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20061030000326 GA Practitioner - Family Practice 7810994100 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
The Emory Clinic IncGroup PAC ID 8820901408, 3,507 clinicians
Emory Specialty Associates, LLCGroup PAC ID 3476559782, 706 clinicians

Practice addresses (Care Compare)

1365 Clifton Rd NE
Atlanta, GA 30322-1013
Phone (404) 778-7525

1821 Clifton Rd NE
Atlanta, GA 30329-4021
Phone (404) 728-6812

Hospital & facility affiliations

  • Centerwell Home Health Home health agency, Kennesaw, GA, CCN 117027
  • Staff Builders Home Health, an Amedisys Company Home health agency, Duluth, GA, CCN 117083
  • Emory Johns Creek Hospital Hospital, Johns Creek, GA, CCN 110230
  • Saint Joseph'S Hospital of Atlanta, Inc Hospital, Atlanta, GA, CCN 110082
  • Northside Hospital Duluth Hospital, Duluth, GA, CCN 110252
  • Emory University Hospital Midtown Hospital, Atlanta, GA, CCN 110078
  • Emory University Hospital Hospital, Atlanta, GA, CCN 110010

Merit-based Incentive Payment System (MIPS)

Final score
94.51 of 100Reported as apm
Quality
80.61
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
The Emory Clinic Inc CurrentSince Feb 1, 2022 Accepting new patients
Emory Specialty Associates, LLC Family Medicine CurrentSince Jan 1, 2012 Accepting new patients
The Medical Group of Saint Joseph'S, LLC Past Accepting new patients

Locations

2201 Henderson Mill Rd NE
Ste 160
Atlanta, GA 30345
Phone (404) 251-2193

1821 Clifton Rd NE
Atlanta, GA 30329
Phone (404) 728-6812

1365 Clifton Rd NE
Atlanta, GA 30322
Phone (404) 778-7525

4855 River Green Pkwy
Ste 700
Duluth, GA 30096
Phone (770) 545-8332

Interoperability endpoints

  • Direct secure messaging: nmizrahi20153@direct.emory.org

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 and National Provider Directory roles.

Hospital & facility affiliations 8

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": "1159228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1291334400000",
    "number": "1104927565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4855 RIVER GREEN PKWY",
            "address_2": "SUITE 700",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "300968336",
            "telephone_number": "770-622-0880",
            "fax_number": "770-622-9875"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4855 RIVER GREEN PKWY",
            "address_2": "SUITE 700",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "300968336",
            "telephone_number": "770-622-0880",
            "fax_number": "770-622-9875"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIZRAHI",
        "first_name": "NELLY",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-26",
        "last_updated": "2010-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "058545",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GA LICENSE",
            "identifier": "058545",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "170546490A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Duluth, GA

Sources for this page

Verify at the official NPI Registry.