Individual provider Active NPI

Mahsa Katherine Masoudi, OD

  • Optometrist
  • Atlanta, GA
National Provider Identifier
1194396309
Registry record updated Jul 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPT003344 Issued in GA
Practice address
5505 Peachtree Dunwoody Rd Ste 300
Atlanta, GA 30342-1718
Phone
(404) 257-0814
NPI assigned
Jul 8, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Corneal and Contact Management Optometrist 152WC0802X OPT003344 GA
Optometrist 152W00000X OPT003344 GA Primary

Addresses

Primary practice location

5505 Peachtree Dunwoody Rd Ste 300
Atlanta, GA 30342-1718

Mailing address

3967 Chapel Grove Dr
Marietta, GA 30062-1067

Other practice location 1

3200 Downwood Cir NW Ste 240
Atlanta, GA 30327-1618
Phone (404) 355-7000

Other practice location 2

1800 Phoenix Blvd Ste 406
College Park, GA 30349-5560
Phone (770) 996-6664

Medicare participation

Medicare enrollment files
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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220328001560 GA Practitioner - Optometry 7214322379 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of California - School of Optometry, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Marietta Eye Clinic, PAGroup PAC ID 0143210427, 39 clinicians

Practice addresses (Care Compare)

3939 Roswell Rd
Suite 100
Marietta, GA 30062-6283
Phone (770) 977-8000

Merit-based Incentive Payment System (MIPS)

Final score
93.93 of 100Reported as apm
Quality
82.14
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPT003344GAMDCorneal and Contact Management Optometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Marietta Eye Clinic, PA Optometrist CurrentSince Dec 9, 2021 Accepting new patients
Marietta Eye Clinic PA CurrentSince Dec 9, 2021 Accepting new patients
Marietta Eye Clinic PA Current Accepting new patients
Marietta Eye Clinic, PA Past Accepting new patients
Southeast Eye Surgery Center, PC PastSince Mar 1, 2021 Accepting new patients

Locations

100 Old Ball Ground Hwy
#A
Canton, GA 30114

3939 Roswell Rd
Ste 100
Marietta, GA 30062
Phone (770) 977-8000

895 Canton Rd NE
Bldg 100
Marietta, GA 30060
Phone (770) 425-6167

10485 Alpharetta St
Roswell, GA 30075
Phone (678) 439-2443

Interoperability endpoints

  • Direct secure messaging: mmasoudi@mariettaeyeclinic.emadirect.md
  • Direct secure messaging: mahsa.masoudi.p41@direct.omnieyeatlanta.nextgenshare.com
  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 5

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": "1625702400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625702400000",
    "number": "1194396309",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3967 CHAPEL GROVE DR",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300621067"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5505 PEACHTREE DUNWOODY RD STE 300",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303421718",
            "telephone_number": "404-257-0814"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3200 Downwood Cir NW Ste 240",
            "address_purpose": "LOCATION",
            "city": "Atlanta",
            "state": "GA",
            "postal_code": "303271618",
            "country_code": "US",
            "telephone_number": "404-355-7000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1800 Phoenix Blvd Ste 406",
            "address_purpose": "LOCATION",
            "city": "College Park",
            "state": "GA",
            "postal_code": "303495560",
            "country_code": "US",
            "telephone_number": "770-996-6664",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MASOUDI",
        "first_name": "MAHSA",
        "middle_name": "KATHERINE",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-08",
        "last_updated": "2021-07-08",
        "certification_date": "2021-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "GA",
            "license": "OPT003344",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "GA",
            "license": "OPT003344",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.