Individual provider Active NPI

Brian Sydow, MD

  • Diagnostic Radiology Physician
  • Atlanta, GA
National Provider Identifier
1124178405
Registry record updated May 6, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
059028 Issued in GA
Practice address
1000 Johnson Ferry Rd NE
Radiology Department
Atlanta, GA 30342-1606
Phone
(404) 851-8000
NPI assigned
Jan 11, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 6, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X MT049745 PA
Diagnostic Radiology Physician 2085R0202X 059028 GA Primary

Addresses

Primary practice location

1000 Johnson Ferry Rd NE
Radiology Department
Atlanta, GA 30342-1606

Mailing address

5605 Glenridge Dr Ste 325
Atlanta, GA 30342-1365
Phone (678) 553-7783

Other identifiers 1

IdentifierTypeStateIssuer
350377757MedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, NJ2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20070501000105 GA Practitioner - Diagnostic Radiology 4082710538 Reassigns benefits to 6 organizations
I20240809001038 NJ Practitioner - Diagnostic Radiology 4082710538 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northside Radiology Associates LLCGroup PAC ID 4486555398, 381 clinicians
Progressive Physician Assoc IncGroup PAC ID 1355243809, 164 clinicians
Intermountain Medical Imaging LLCGroup PAC ID 7517870918, 35 clinicians
Gem State Radiology LLPGroup PAC ID 9335044833, 60 clinicians

Practice addresses (Care Compare)

1000 Johnson Ferry Rd
Atlanta, GA 30342-1606
Phone (404) 662-2438

1000 Johnson Ferry Rd NE
Atlanta, GA 30342-1606
Phone (404) 662-2438

11014 Taconic Way
Johns Creek, GA 30097-1937
Phone (800) 475-6112

1400 Hembree Rd
Suite 150
Roswell, GA 30076-5711
Phone (404) 851-6577

185 Roseberry St
Phillipsburg, NJ 08865-1690
Phone (908) 859-6700

2859 N Decatur Rd
Decatur, GA 30033-5911
Phone (404) 851-6577

3400 Old Milton Pkwy
Suite C110
Alpharetta, GA 30005-3769
Phone (404) 851-6577

4800 Olde Towne Pkwy
Suite 100
Marietta, GA 30068-4357
Phone (404) 851-6577

758 Old Norcross Rd
Suite 100
Lawrenceville, GA 30046-3386
Phone (404) 662-2438

Hospital & facility affiliations

  • Northside Hospital Forsyth Hospital, Cumming, GA, CCN 110005
  • St Lukes Hospital Hospital, Bethlehem, PA, CCN 390049
  • Northside Hospital Cherokee Hospital, Canton, GA, CCN 110008
  • Northside Hospital Hospital, Atlanta, GA, CCN 110161
  • St Luke'S Hospital - Monroe Campus Hospital, Stroudsburg, PA, CCN 390330

Merit-based Incentive Payment System (MIPS)

Final score
96.75 of 100Reported as group
Quality
96.18
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MT049745PAMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Gem State Radiology LLP Diagnostic Radiology CurrentSince Feb 1, 2025 Accepting new patients
Intermountain Medical Imaging LLC Diagnostic Radiology CurrentSince Feb 1, 2025 Accepting new patients
Progressive Physician Assoc Inc Diagnostic Radiology CurrentSince Jun 1, 2024 Accepting new patients
Northside Radiology Associates LLC Diagnostic Radiology CurrentSince Jul 1, 2007 Accepting new patients
Intermountain Medical Imaging LLC Diagnostic Radiology CurrentSince Feb 1, 2025 Accepting new patients
Pontchartrain Diagnostic Imaging LLC Diagnostic Radiology Past Accepting new patients
Intermountain Medical Imaging LLC Diagnostic Radiology Past Accepting new patients
Open MRI and CT Specialists of Stockbridge Diagnostic Radiology PastSince Mar 16, 2009 Accepting new patients

Locations

100 Galleria Pkwy SE
Ste 1450
Atlanta, GA 30339
Phone (770) 952-8899

1000 Johnson Ferry Rd
Sandy Springs, GA 30342
Phone (404) 851-8737

5445 Meridian Mark Rd
Ste 450
Sandy Springs, GA 30342
Phone (404) 459-1875

5605 Glenridge Dr
Ste 325
Sandy Springs, GA 30342
Phone (678) 553-7783

927 W Myrtle St
Boise, ID 83702
Phone (208) 367-7510

1055 N Curtis Rd
Boise, ID 83706
Phone (208) 367-2152

323 E Riverside Dr
Ste 108
Eagle, ID 83616
Phone (208) 367-5700

875 S Vanguard Way
Ste 100
Meridian, ID 83642
Phone (208) 954-8100

2929 E Magic View Dr
Meridian, ID 83642
Phone (208) 367-8222

185 Roseberry St
Phillipsburg, NJ 08865
Phone (908) 213-6611

801 Ostrum St
Fountain Hill, PA 18015
Phone (610) 954-2200

Organizations & group practices 10

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 10

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": "1168473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1557100800000",
    "number": "1124178405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5605 GLENRIDGE DR STE 325",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303421365",
            "telephone_number": "678-553-7783",
            "fax_number": "678-553-7793"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 JOHNSON FERRY RD NE",
            "address_2": "RADIOLOGY DEPARTMENT",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303421606",
            "telephone_number": "404-851-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SYDOW",
        "first_name": "BRIAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-11",
        "last_updated": "2019-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "PA",
            "license": "MT049745",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "GA",
            "license": "059028",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "350377757",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.