Individual provider Active NPI

Amina Hassanali, M.D.

  • General Practice Physician
  • Decatur, GA
National Provider Identifier
1124013495
Registry record updated Aug 19, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
045494 Issued in GA
Practice address
1829 Lawrenceville Hwy
Decatur, GA 30033-5728
Phone
(404) 292-8335
Fax
(404) 343-3737
NPI assigned
Sep 13, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 045494 GA Primary

Addresses

Primary practice location

1829 Lawrenceville Hwy
Decatur, GA 30033-5728

Mailing address

2840 NE Expy NE
Ste 116
Atlanta, GA 30345-4225
Phone (770) 717-1828

Other identifiers 1

IdentifierTypeStateIssuer
00806935EMedicaidGA

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
I20141013002546 GA Practitioner - General Practice 3072733146 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Practice
Education
Other, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

2840 Northeast Expy NE
Suite 116
Atlanta, GA 30345-4225
Phone (404) 201-0125

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
045494GAMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
S4 Smart Family Care LLC CurrentSince Apr 2, 2025 Accepting new patients
Amina Medical Consultants PC CurrentSince Sep 11, 2014 Accepting new patients
Park Central Family Practice, Inc. PastSince Apr 28, 2015 Accepting new patients
Georgia Clinic, PC Past Accepting new patients

Locations

2840 Ne
Ste 116
Atlanta, GA 30345
Phone (404) 201-0125

2840 Ne
Atlanta, GA 30345
Phone (404) 929-1402

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 4

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": "1126569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566172800000",
    "number": "1124013495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2840 NE EXPY NE",
            "address_2": "STE 116",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303454225",
            "telephone_number": "770-717-1828",
            "fax_number": "770-717-8284"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1829 LAWRENCEVILLE HWY",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300335728",
            "telephone_number": "404-292-8335",
            "fax_number": "404-343-3737"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HASSANALI",
        "first_name": "AMINA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-13",
        "last_updated": "2019-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "GA",
            "license": "045494",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00806935E",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Decatur, GA

Sources for this page

Verify at the official NPI Registry.