Gordon Jerome Azar Jr., M.D., F.A.C.C.

Primary specialty

Cardiovascular Disease PhysicianTaxonomy code 207RC0000X

License

31380 Issued in GA

Practice address

460 Northside Cherokee Blvd Ste 150
Canton, GA 30115-8018

Phone

(470) 639-6250

Fax

(770) 345-0712

NPI assigned

Oct 26, 2005

Sex

Male

Sole proprietor

No

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.

• Saint Josephs Hospital of Atlanta Inc

  • General Acute Care Hospital
  • Atlanta, GA
  • NPI 1679664395

  GA

  Medicare reassignment NPD
• Saint Josephs Hospital of Atlanta Inc

  • Community/Retail Pharmacy
  • Atlanta, GA
  • NPI 1497724181
  NPD
• North Fulton Regional Medical Center Pro Fee Billing, LLC

  • Cardiovascular Disease Physician
  • Roswell, GA
  • NPI 1013142744

  Cardiovascular Disease

  NPD (past)

Merit-based Incentive Payment System (MIPS)

Final score

77.82 of 100Reported as group

Quality

67.82

Promoting interoperability

77

Improvement activities

40

Cost

77.43

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.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Feb 16, 2024.

{
    "created_epoch": "1130284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708041600000",
    "number": "1144210642",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "460 NORTHSIDE CHEROKEE BLVD STE 150",
            "city": "CANTON",
            "state": "GA",
            "postal_code": "301158018",
            "telephone_number": "470-639-6250",
            "fax_number": "770-345-0712"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "460 NORTHSIDE CHEROKEE BLVD STE 150",
            "city": "CANTON",
            "state": "GA",
            "postal_code": "301158018",
            "telephone_number": "470-639-6250",
            "fax_number": "770-345-0712"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AZAR",
        "first_name": "GORDON",
        "middle_name": "JEROME",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "M.D., F.A.C.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-26",
        "last_updated": "2024-02-16",
        "certification_date": "2024-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "GA",
            "license": "31380",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00433815C",
            "state": "GA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "NorthsideHeart@Northside.gwaydirect.com",
            "affiliation": "N",
            "endpointDescription": "Direct Messaging",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Direct Edge",
            "address_1": "460 Northside Cherokee Blvd Ste 190",
            "city": "Canton",
            "state": "GA",
            "country_code": "US",
            "postal_code": "301158018",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Sayonara I Aybar, M.ED, ACAS
• Aylo Health, LLC
• Aylo Health, LLC
• India Nicole Ayoub
• Amal Azar, PHARMD
• Nader Baaklini
• Jennifer Bacchus, PHARMD
• Back 2 Back Chiropractic Canton LLC
• Back to Life
• Back to Life Medical Group, LLC

• All providers in Canton, GA
• Cardiovascular Disease Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.