Individual provider Active NPI

Aditya Saholi, MD

  • Internal Medicine Physician
  • Bridgeport, CT
National Provider Identifier
1225609126
Registry record updated May 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
99883 Issued in GA
Practice address
2800 Main Street
Dept of Medicine
Bridgeport, CT 06606
Phone
(475) 210-5425
Fax
(475) 210-5022
NPI assigned
Jul 2, 2021
Last updated
May 9, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 9, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Internal Medicine Physician 207R00000X 99883 GA Primary

Addresses

Primary practice location

2800 Main Street
Dept of Medicine
Bridgeport, CT 06606

Mailing address

2800 Main Street
Dept of Medicine
Bridgeport, CT 06606
Phone (475) 210-5425

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
I20240513001004 GA Practitioner - Internal Medicine 7719328491 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2020
Medicare assignment
May accept Medicare assignment
Group practices
Apogee Medical Group GeorgiaGroup PAC ID 4587676945, 122 clinicians

Practice addresses (Care Compare)

705 Dixie St
Carrollton, GA 30117-3818
Phone (770) 812-9666

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
99883GAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Apogee Medical Group Georgia Inc Internal Medicine CurrentSince May 9, 2024 Accepting new patients
Tanner Medical Center, Inc Past Accepting new patients

Locations

705 Dixie St
Carrollton, GA 30117
Phone (770) 812-9666

2501 N Patterson St
Valdosta, GA 31602
Phone (229) 259-4139

601 Dallas Hwy
Villa Rica, GA 30180
Phone (770) 456-3000

Interoperability endpoints

  • Direct secure messaging: asaholi577420@direct.ochin.org

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 4

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": "1625184000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715212800000",
    "number": "1225609126",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2800 MAIN STREET",
            "address_2": "DEPT OF MEDICINE",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "06606",
            "telephone_number": "475-210-5425",
            "fax_number": "475-210-5022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2800 MAIN STREET",
            "address_2": "DEPT OF MEDICINE",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "06606",
            "telephone_number": "475-210-5425",
            "fax_number": "475-210-5022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAHOLI",
        "first_name": "ADITYA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-07-02",
        "last_updated": "2024-05-09",
        "certification_date": "2024-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "99883",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bridgeport, CT

Sources for this page

Verify at the official NPI Registry.