Individual provider Active NPI

Nassim Nabavi, PA-C

  • Medical Physician Assistant
  • Marietta, GA
National Provider Identifier
1205297983
Registry record updated Apr 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
7911 Issued in GA
Practice address
2857 Carnegie Way SW
Marietta, GA 30064-4091
Phone
(770) 354-4084
NPI assigned
Mar 9, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 7911 GA Primary

Addresses

Primary practice location

2857 Carnegie Way SW
Marietta, GA 30064-4091

Mailing address

2857 Carnegie Way SW
Marietta, GA 30064-4091

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
I20160321001548 GA Practitioner - Physician Assistant 8729385653 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
87.82 of 100Reported as apm
Quality
79.78
Promoting interoperability
93.11
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
007911GAMDChiropractor
7911GAMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Neurological Asssociate of Augusta, PC CurrentSince Feb 1, 2026 Accepting new patients
Dekalb Medical Specialty Care Group LLC Past Accepting new patients

Locations

1210 Roy Rd
Augusta, GA 30909
Phone (706) 724-9607

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/23795/brand/1/csg/1/fhir/r4

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": "1457481600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744070400000",
    "number": "1205297983",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2857 CARNEGIE WAY SW",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300644091"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2857 CARNEGIE WAY SW",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300644091",
            "telephone_number": "770-354-4084"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NABAVI",
        "first_name": "NASSIM",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-03-09",
        "last_updated": "2025-04-08",
        "certification_date": "2025-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "GA",
            "license": "7911",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marietta, GA

Sources for this page

Verify at the official NPI Registry.