Individual provider Active NPI

Syed A Agha, MD

  • Interventional Cardiology Physician
  • Cleveland, TN
National Provider Identifier
1164420741
Registry record updated Oct 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Cardiology PhysicianTaxonomy code 207RI0011X
License
55598 Issued in TN
Practice address
2292 Chambliss Ave NW Ste F
Cleveland, TN 37311-3862
Phone
(423) 919-1577
NPI assigned
Jul 8, 2005
Last updated
Oct 2, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Interventional Cardiology Physician 207RI0011X MD70050075 WA
Interventional Cardiology Physician 207RI0011X N2899 TX
Interventional Cardiology Physician 207RI0011X 55598 TN Primary
Interventional Cardiology Physician 207RI0011X 59357 GA

Addresses

Primary practice location

2292 Chambliss Ave NW Ste F
Cleveland, TN 37311-3862

Mailing address

2292 Chambliss Ave NW Ste F
Cleveland, TN 37311-3862
Phone (423) 919-1577

Other practice location 1

2101 NE 139th St Ste 360
Vancouver, WA 98686-2313
Phone (360) 487-1965

Other identifiers 1

IdentifierTypeStateIssuer
091420207MedicaidGA

Other names 1

  • Abbas Agha Professional name

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address syed.agha.1@1525.direct.athenahealth.com
Direct Messaging Address syed.agha.1@1525.direct.athenahealth.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, TN, WA, OR, KS5 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 5

Enrollment IDStateProvider typePAC IDDetails
I20071113000568 GA Practitioner - Interventional CardiologyPractitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 9436108024 Reassigns benefits to 2 organizations
I20200211000471 TN Practitioner - Interventional Cardiology 9436108024 Reassigns benefits to 1 organization
I20251017001312 WA Practitioner - Interventional Cardiology 9436108024 Reassigns benefits to 1 organization
I20251221000144 OR Practitioner - Interventional CardiologyPractitioner - Cardiovascular Disease (Cardiology) 9436108024 Reassigns benefits to 5 organizations
I20260323003147 KS Practitioner - Interventional CardiologyPractitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 9436108024 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Interventional CardiologyAlso: Cardiovascular Disease (Cardiology)
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Legacy Clinics LLCGroup PAC ID 0244144004, 714 clinicians
Legacy Salmon Creek HospitalGroup PAC ID 0446295711, 309 clinicians
Abbas Agha M D PLLCGroup PAC ID 8325418932, 2 clinicians
Salina Regional Health Center IncGroup PAC ID 0446168215, 160 clinicians

Practice addresses (Care Compare)

1015 NW 22ND Ave
Portland, OR 97210-3025
Phone (503) 413-7711

1015 Nw22Nd Ave
Suite 34
Portland, OR 97210-3025
Phone (503) 413-6376

1040 NW 22ND Ave
Suite 630
Portland, OR 97210-3041
Phone (503) 413-7162

1130 NW 22ND Ave
Suite 220
Portland, OR 97210-2969
Phone (503) 413-8988

19250 SW 65TH Ave
Suite 265
Tualatin, OR 97062-7747
Phone (503) 413-6862

19300 SW 65TH Ave
Meridian Park Hosp
Portland, OR 97062-7706
Phone (503) 692-1212

2101 NE 139TH St
Suite 360
Vancouver, WA 98686-2313
Phone (360) 487-1965

2292 Chambliss Ave NW
Suite F
Cleveland, TN 37311-3862
Phone (423) 919-1577

400 S Santa Fe Ave
Salina, KS 67401-4144

501 S Santa Fe Ave
Salina, KS 67401-4106

501 S Santa Fe Ave
Salina, KS 67401-4189

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting16
Varicose vein removal27
Leg revascularization (restoring blood flow)1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2012025750MOMDFamily Medicine Physician
59357GAMDInterventional Cardiology Physician
55598TNMDInterventional Cardiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Legacy Emanuel Hospital & Health Center CurrentSince Oct 24, 2025 Accepting new patients
Legacy Meridian Park Hospital CurrentSince Oct 24, 2025 Accepting new patients
Abbas Agha MD PLLC Interventional Cardiology CurrentSince Nov 25, 2022 Accepting new patients
Legacy Meridian Park Hospital CurrentSince Oct 24, 2025 Accepting new patients
Hamilton Physician Group Inc CurrentSince Oct 1, 2016 Accepting new patients
Legacy Mount Hood Medical Center CurrentSince Oct 24, 2025 Accepting new patients
Legacy Salmon Creek Hospital CurrentSince Oct 2, 2025 Accepting new patients
Legacy Mount Hood Medical Center CurrentSince Oct 24, 2025 Accepting new patients
Legacy Emanuel Hospital & Health Center CurrentSince Oct 24, 2025 Accepting new patients
Hamilton Medical Center, Inc. CurrentSince Dec 17, 2017 Accepting new patients
Legacy Good Samaritan Hospital and Medical Center CurrentSince Oct 24, 2025 Accepting new patients
Legacy Salmon Creek Hospital CurrentSince Oct 2, 2025 Accepting new patients
Legacy Good Samaritan Hospital and Medical Center CurrentSince Oct 24, 2025 Accepting new patients
Legacy Clinics LLC CurrentSince Oct 24, 2025 Accepting new patients
Legacy Good Samaritan Hospital and Medical Center Past Accepting new patients
Dalton Cardiology, P.C. Past Accepting new patients
Legacy Clinics LLC Past Accepting new patients
Washita Emergency Physicians LLC Past Accepting new patients

Locations

1200 Memorial Dr
Dalton, GA 30720
Phone (706) 272-6115

1436 Broadrick Dr
#B
Dalton, GA 30720
Phone (706) 226-3434

1436 Broadrick Dr
Ste B
Dalton, GA 30720
Phone (706) 226-3434

24800 SE Stark St
Gresham, OR 97030
Phone (503) 413-8407

1130 NW 22nd Ave
Ste 220
Portland, OR 97210
Phone (503) 413-4134

1130 NW 22nd Ave
Ste 400
Portland, OR 97210
Phone (503) 413-6555

1200 NW 23rd Ave
Portland, OR 97210
Phone (503) 413-7074

2801 N Gantenbein Ave
Portland, OR 97227
Phone (503) 413-2200

19300 SW 65th Ave
Tualatin, OR 97062
Phone (503) 692-1212

2205 McCallie Ave
Ste 501C
Chattanooga, TN 37404

2333 McCallie Ave
Chattanooga, TN 37404
Phone (423) 493-1387

2292 Chambliss Ave NW
Ste F
Cleveland, TN 37311
Phone (423) 641-4261

2101 NE 139th St
Ste 360
Vancouver, WA 98686
Phone (360) 256-2640

2211 NE 139th St
Vancouver, WA 98686
Phone (360) 397-1985

Interoperability endpoints

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

Organizations & group practices 20

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

View all 20

Hospital & facility affiliations 3

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": "1120780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759363200000",
    "number": "1164420741",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2292 CHAMBLISS AVE NW STE F",
            "city": "CLEVELAND",
            "state": "TN",
            "postal_code": "373113862",
            "telephone_number": "423-919-1577"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2292 CHAMBLISS AVE NW STE F",
            "city": "CLEVELAND",
            "state": "TN",
            "postal_code": "373113862",
            "telephone_number": "423-919-1577"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2101 NE 139th St Ste 360",
            "address_purpose": "LOCATION",
            "city": "Vancouver",
            "state": "WA",
            "postal_code": "986862313",
            "country_code": "US",
            "telephone_number": "360-487-1965",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AGHA",
        "first_name": "SYED",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-08",
        "last_updated": "2025-10-02",
        "certification_date": "2025-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "WA",
            "license": "MD70050075",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "TX",
            "license": "N2899",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "TN",
            "license": "55598",
            "primary": true
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "GA",
            "license": "59357",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "091420207",
            "state": "GA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "syed.agha.1@1525.direct.athenahealth.com",
            "affiliation": "N",
            "endpointDescription": "AMR Direct Address",
            "address_1": "1436 Broadrick Dr Ste B",
            "city": "Dalton",
            "state": "GA",
            "country_code": "US",
            "postal_code": "307203009",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "syed.agha.1@1525.direct.athenahealth.com",
            "affiliation": "N",
            "address_1": "1436 Broadrick Dr Ste B",
            "city": "Dalton",
            "state": "GA",
            "country_code": "US",
            "postal_code": "307203009",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "ABBAS",
            "last_name": "AGHA",
            "credential": "M.D.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Cleveland, TN

Sources for this page

Verify at the official NPI Registry.