Individual provider Active NPI

Amit Thakral, MD

  • Pediatric Rheumatology Physician
  • Atlanta, GA
National Provider Identifier
1194019323
Registry record updated Jun 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Rheumatology PhysicianTaxonomy code 2080P0216X
License
78597 Issued in GA
Practice address
1400 Tullie Rd NE FL 2
Atlanta, GA 30329-2309
Phone
(404) 785-5437
Fax
(404) 785-9096
NPI assigned
Jun 6, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 6, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Rheumatology Physician 2080P0216X 78597 GA Primary

Addresses

Primary practice location

1400 Tullie Rd NE FL 2
Atlanta, GA 30329-2309

Mailing address

1400 Tullie Rd NE FL 2
Atlanta, GA 30329-2309
Phone (404) 785-5437

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address choa@choa.gadirect.net

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20240109001431 TX Practitioner - RheumatologyPractitioner - Pediatric Medicine 4789957614 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
RheumatologyAlso: Pediatric Medicine
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Texas Childrens Physician GroupGroup PAC ID 4385722081, 661 clinicians

Practice addresses (Care Compare)

8611 N Mopac Expy
Austin, TX 78759-8319
Phone (832) 824-1000

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
78597GAMDPediatric Rheumatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Children's Physician Group Pediatrics CurrentSince Dec 28, 2023 Accepting new patients
Hospital Authority of the City of Bainbridge and Decatur County Past Accepting new patients

Locations

8611 N Mopac Expy
Austin, TX 78759
Phone (713) 816-1250

6701 Fannin St
Houston, TX 77030
Phone (832) 822-1764

Interoperability endpoints

  • Direct secure messaging: athakral416752@prddirect.texaschildrens.org

Organizations & group practices 2

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": "1307318400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654473600000",
    "number": "1194019323",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 TULLIE RD NE FL 2",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303292309",
            "telephone_number": "404-785-5437",
            "fax_number": "404-785-9096"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 TULLIE RD NE FL 2",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303292309",
            "telephone_number": "404-785-5437",
            "fax_number": "404-785-9096"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THAKRAL",
        "first_name": "AMIT",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-06-06",
        "last_updated": "2022-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0216X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Rheumatology",
            "state": "GA",
            "license": "78597",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "choa@choa.gadirect.net",
            "affiliation": "N",
            "address_1": "1400 Tullie Rd NE Fl 2",
            "city": "Atlanta",
            "state": "GA",
            "country_code": "US",
            "postal_code": "303292309",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.