Anjan Deka, M.D.

Primary specialty

Interventional Cardiology PhysicianTaxonomy code 207RI0011X

License

82555 Issued in GA

Practice address

460 Northside Cherokee Blvd Ste 190
Canton, GA 30115-8018

Phone

(470) 639-6250

Fax

(770) 345-0712

NPI assigned

Apr 17, 2011

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Electronic endpoints 1

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.

Enrollment records 1

Specialty

Cardiovascular Disease (Cardiology)Also: Internal Medicine, Interventional Cardiology

Education

Emory University School of Medicine, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Harbin Clinic LLCGroup PAC ID 0446154231, 238 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Atrium Health Floyd Medical Center Hospital, Rome, GA, CCN 110054
• Atrium Health Floyd Polk Medical Center Hospital, Cedartown, GA, CCN 111330
• Adventhealth Redmond Hospital, Rome, GA, CCN 110168

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

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Interoperability endpoints

• Direct secure messaging: adeka3022370@carolinashealthcaresystem.direct-ci.com

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.

• Harbin Clinic, LLC

  dba Harbin Clinic

  • Multi-Specialty Clinic/Center
  • Rome, GA
  • NPI 1679599088
  Medicare reassignment Care Compare group

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Floyd Healthcare Management Inc

  dba Atrium Health Floyd Medical Center

  • General Acute Care Hospital
  • Rome, GA
  • NPI 1154377166
  Care Compare affiliation
• Polk Medical Center, Inc

  dba Atrium Health Floyd Polk Medical Center

  • Critical Access Hospital
  • Cedartown, GA
  • NPI 1073927117
  Care Compare affiliation
• Redmond Park Hospital, LLC

  dba Adventhealth Redmond

  • General Acute Care Hospital
  • Rome, GA
  • NPI 1508810565
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1302998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1205126851",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9200 W WISCONSIN AVENUE",
            "address_2": "DIVISON OF CARDIOLOGY",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532263522",
            "telephone_number": "414-955-5611",
            "fax_number": "414-456-6515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "460 NORTHSIDE CHEROKEE BLVD STE 190",
            "city": "CANTON",
            "state": "GA",
            "postal_code": "301158018",
            "telephone_number": "470-639-6250",
            "fax_number": "770-345-0712"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Zablocki Va Medical Center Div Of Cardiology Ave",
            "address_purpose": "LOCATION",
            "city": "Milwaukee",
            "state": "WI",
            "postal_code": "532953833",
            "country_code": "US",
            "telephone_number": "414-384-2000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9200 W WISCONSIN AVENUE",
            "address_2": "DIVISON OF CARDIOLOGY",
            "address_purpose": "LOCATION",
            "city": "Milwaukee",
            "state": "WI",
            "postal_code": "532263522",
            "country_code": "US",
            "telephone_number": "414-955-5611",
            "fax_number": "414-456-6515",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DEKA",
        "first_name": "ANJAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-04-17",
        "last_updated": "2022-07-21",
        "certification_date": "2020-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "WI",
            "license": "6745320",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "IL",
            "license": "036.135578",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "GA",
            "license": "82555",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1205126851",
            "state": "WI"
        }
    ],
    "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": []
}

• Sandra E Deconza, PA-C
• Jill M Decorso
• Dedciated Physical Therapy, LLC
• Drake Christian Dehoff, MD
• Logan Barrett Dehoff, MD
• Andrea Delagarza, D.C
• Demyen Family Chiropractic Inc
• Gracelyn Ambrister Deneus, FNP
• Tia Fortes Denkinger, M.S., CCC-SLP
• Catherine Lynn Denner, PHARM.D.

• Interventional Cardiology Physician in Canton, GA
• Providers in Canton, GA by specialty
• Interventional Cardiology Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.