Individual provider Active NPI

Nastasia Ardalan, MSN, NP-C, ACHPN

  • Nurse Practitioner
  • Atlanta, GA
National Provider Identifier
1205223179
Registry record updated Mar 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
232298 Issued in GA
Practice address
1000 Johnson Ferry Rd
Atlanta, GA 30342-1606
Phone
(404) 851-8000
Fax
(404) 303-3759
NPI assigned
Apr 18, 2015
Last updated
Mar 24, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 232298 GA Primary

Addresses

Primary practice location

1000 Johnson Ferry Rd
Atlanta, GA 30342-1606

Mailing address

4514 Chamblee Dunwoody Rd Unit 165
Atlanta, GA 30338-6272

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150826001591 GA Practitioner - Nurse Practitioner 4082920723 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Atlanta Professional Services LLCGroup PAC ID 0840291944, 423 clinicians

Practice addresses (Care Compare)

1000 Johnson Ferry Rd NE
Atlanta, GA 30342-1606
Phone (404) 851-8000

1200 Northside Forsyth Dr
Cumming, GA 30041-7659
Phone (770) 844-3200

450 Northside Cherokee Blvd
Canton, GA 30115-8015
Phone (770) 224-1000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
98.79 of 100Reported as group
Quality
98.74
Improvement activities
40
Cost
83.11

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing

State licenses

LicenseStateTypeSpecialty
232298GAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
North Atlanta Professional Services LLC CurrentSince Jun 20, 2015 Accepting new patients
Northside Cardiovascular Professional Services, LLC PastSince Feb 1, 2011 Accepting new patients

Locations

1000 Medical Center Blvd
Lawrenceville, GA 30046
Phone (678) 312-3356

1000 Johnson Ferry Rd
Sandy Springs, GA 30342
Phone (404) 851-8737

1000 Johnson Fy Rd NE
Sandy Springs, GA 30342
Phone (404) 851-1000

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1429315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585008000000",
    "number": "1205223179",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4514 CHAMBLEE DUNWOODY RD UNIT 165",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303386272"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 JOHNSON FERRY RD",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303421606",
            "telephone_number": "404-851-8000",
            "fax_number": "404-303-3759"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ARDALAN",
        "first_name": "NASTASIA",
        "credential": "MSN, NP-C, ACHPN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-18",
        "last_updated": "2020-03-24",
        "certification_date": "2020-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "GA",
            "license": "232298",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.