Individual provider Active NPI

Balsam S Elhammali, MD

  • Internal Medicine Physician
  • Atlanta, GA
National Provider Identifier
1215037205
Registry record updated Jul 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
58412 Issued in GA
Practice address
80 Jesse Hill Jr Dr Ste 100
Atlanta, GA 30303-3031
Phone
(404) 616-7578
NPI assigned
Sep 22, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 6, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 58412 GA Primary

Addresses

Primary practice location

80 Jesse Hill Jr Dr Ste 100
Atlanta, GA 30303-3031

Mailing address

720 Westview Drive SW
Harris BLDG., 100-a
Atlanta, GA 30310
Phone (404) 756-1400

Other identifiers 1

IdentifierTypeStateIssuer
992399413CMedicaidGA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address belhammali3414@direct.gmh.edu Direct

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20061221000433 GA Practitioner - Internal Medicine 8022018035 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Morehouse Healthcare, Inc.Group PAC ID 6002701273, 155 clinicians

Practice addresses (Care Compare)

80 Jesse Hill Jr Dr NE
Atlanta, GA 30303-2613
Phone (404) 756-1410

Hospital & facility affiliations

  • Grady Memorial Hospital Hospital, Atlanta, GA, CCN 110079

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
58412GAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Morehouse Healthcare, Inc. Internal Medicine CurrentSince Jul 1, 2006 Accepting new patients

Locations

80 Jesse Hill Jr Dr SE
Ste 100
Atlanta, GA 30303
Phone (404) 616-7578

720 Westview Dr SW
Bldg 100A
Atlanta, GA 30310

75 Piedmont Ave NE
Ste 700
Atlanta, GA 30303
Phone (404) 756-1410

80 Jesse Hill Jr Dr SE
Atlanta, GA 30303
Phone (404) 616-4370

1595 Cleveland Ave
East Point, GA 30344
Phone (404) 305-8086

Organizations & group practices 1

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.

Hospital & facility affiliations 1

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": "1158883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625529600000",
    "number": "1215037205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "720 WESTVIEW DRIVE SW",
            "address_2": "HARRIS BLDG., 100-A",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "30310",
            "telephone_number": "404-756-1400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "80 JESSE HILL JR DR STE 100",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303033031",
            "telephone_number": "404-616-7578"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELHAMMALI",
        "first_name": "BALSAM",
        "middle_name": "S",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-22",
        "last_updated": "2021-07-06",
        "certification_date": "2021-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "58412",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "992399413C",
            "state": "GA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "belhammali3414@direct.gmh.edu",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/PDF/TXT",
            "address_1": "80 JESSE HILL JR DR STE 100",
            "city": "ATLANTA",
            "state": "GA",
            "country_code": "US",
            "postal_code": "303033031",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.