Individual provider Active NPI

Marwan Mujid Kazimi, M.D.

  • Surgery Physician
  • Atlanta, GA
National Provider Identifier
1235302415
Registry record updated Mar 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
290089 Issued in MA
Practice address
1365 Clifton Rd NE BLDG B
Atlanta, GA 30322-5501
Phone
(855) 366-7989
Fax
(404) 712-2617
NPI assigned
Apr 8, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 290089 MA Primary
Transplant Surgery Physician 204F00000X 074439 GA

Addresses

Primary practice location

1365 Clifton Rd NE BLDG B
Atlanta, GA 30322-5501

Mailing address

1365 Clifton Rd NE BLDG B
Atlanta, GA 30322-1013
Phone (855) 366-7989

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, MA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20150925001382 GA Practitioner - General Surgery 3274691340 Reassigns benefits to 2 organizations
I20211025000189 MA Practitioner - General Surgery 3274691340 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
The Emory Clinic IncGroup PAC ID 8820901408, 3,507 clinicians

Practice addresses (Care Compare)

1365 Clifton Rd NE
Atlanta, GA 30322-1013
Phone (404) 778-7525

Hospital & facility affiliations

  • Emory University Hospital Hospital, Atlanta, GA, CCN 110010

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
074439GAMDTransplant Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Emory Clinic Inc Transplant Surgery CurrentSince Jun 1, 2023 Accepting new patients
Choa Hospital Based, LLC CurrentSince Apr 19, 2024 Accepting new patients
Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr Inc CurrentSince Oct 7, 2021 Accepting new patients
Choa Multispecialty, LLC Current Accepting new patients
Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr Inc Transplant Surgery CurrentSince Oct 7, 2021 Accepting new patients
Emory Health Care Past Accepting new patients

Locations

1364 Clifton Rd NE
Atlanta, GA 30322
Phone (404) 712-7100

1365 Clifton Rd NE
Atlanta, GA 30322
Phone (404) 778-7525

2201 Henderson Mill Rd NE
Ste 160
Atlanta, GA 30345
Phone (404) 251-2193

1405 Clifton Rd NE
Atlanta, GA 30322
Phone (404) 785-1112

1365 Clifton Rd NE
Bldg B
Atlanta, GA 30322
Phone (404) 778-2020

2015 Upper Gate Dr NE
Atlanta, GA 30322
Phone (404) 778-2400

110 Francis St
Boston, MA 02215
Phone (617) 632-7246

110 Francis St
Bldg 7TH
Boston, MA 02215

330 Brookline Ave
Boston, MA 02215
Phone (617) 667-2000

247 Station Dr
Ste NW1
Westwood, MA 02090
Phone (617) 754-1015

Organizations & group practices 6

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 2

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": "1207612800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679097600000",
    "number": "1235302415",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1365 CLIFTON RD NE BLDG B",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303221013",
            "telephone_number": "855-366-7989",
            "fax_number": "404-712-2617"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1365 CLIFTON RD NE BLDG B",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303225501",
            "telephone_number": "855-366-7989",
            "fax_number": "404-712-2617"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAZIMI",
        "first_name": "MARWAN",
        "middle_name": "MUJID",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-04-08",
        "last_updated": "2023-03-18",
        "certification_date": "2023-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MA",
            "license": "290089",
            "primary": true
        },
        {
            "code": "204F00000X",
            "taxonomy_group": "",
            "desc": "Transplant Surgery",
            "state": "GA",
            "license": "074439",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.