Individual provider Active NPI

Sorabh Kothari, MD

  • Cardiovascular Disease Physician
  • Tucker, GA
National Provider Identifier
1154777167
Registry record updated Mar 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
98548 Issued in GA
Practice address
1468 Montreal Rd
Tucker, GA 30084-6901
Phone
(770) 638-1400
NPI assigned
May 9, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 036147652 IL
Cardiovascular Disease Physician 207RC0000X 036147652 IL
Student in an Organized Health Care Education/Training Program 390200000X
Cardiovascular Disease Physician 207RC0000X 98548 GA Primary

Addresses

Primary practice location

1468 Montreal Rd
Tucker, GA 30084-6901

Mailing address

1468 Montreal Rd
Tucker, GA 30084-6901
Phone (770) 638-1400

Other practice location 1

1875 W Dempster St Ste 525
Park Ridge, IL 60068-1130
Phone (847) 698-3600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, GA2 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
I20190510000359 IL Practitioner - Internal Medicine 7012204118
I20241206001237 GA Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Interventional Cardiology 7012204118 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)Also: Interventional Cardiology
Education
Chicago College of Medicine and Surgery, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Atlanta Heart Specialists LLCGroup PAC ID 9537134341, 21 clinicians

Practice addresses (Care Compare)

1468 Montreal Rd
Tucker, GA 30084-6901
Phone (770) 638-1400

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting31

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036147652ILMDInternal Medicine Physician
98548GAMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Atlanta Heart Specialists LLC Internal Medicine CurrentSince Jul 19, 2024 Accepting new patients
Dekalb Medical Center, Inc. Past Accepting new patients
Dekalb Medical Psych Unit Past Accepting new patients

Locations

2801 N Decatur Rd
Ste 395
Decatur, GA 30033
Phone (404) 298-2220

2665 N Decatur Rd
Ste 320
Decatur, GA 30033
Phone (404) 292-1144

5667 Peachtree Dunwoody Rd
Ste 390
Sandy Springs, GA 30342
Phone (404) 250-4530

1468 Montreal Rd
Tucker, GA 30084
Phone (770) 638-1400

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/FIFCAA

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 4

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": "1462752000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710201600000",
    "number": "1154777167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1468 MONTREAL RD",
            "city": "TUCKER",
            "state": "GA",
            "postal_code": "300846901",
            "telephone_number": "770-638-1400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1468 MONTREAL RD",
            "city": "TUCKER",
            "state": "GA",
            "postal_code": "300846901",
            "telephone_number": "770-638-1400"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1875 W Dempster St Ste 525",
            "address_purpose": "LOCATION",
            "city": "Park Ridge",
            "state": "IL",
            "postal_code": "600681130",
            "country_code": "US",
            "telephone_number": "847-698-3600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KOTHARI",
        "first_name": "SORABH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-05-09",
        "last_updated": "2024-03-12",
        "certification_date": "2024-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036147652",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "IL",
            "license": "036147652",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "GA",
            "license": "98548",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucker, GA

Sources for this page

Verify at the official NPI Registry.