Individual provider Active NPI

Salim Thabet, M.D.

  • Interventional Cardiology Physician
  • Lawrenceville, GA
National Provider Identifier
1255607255
Registry record updated Apr 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Cardiology PhysicianTaxonomy code 207RI0011X
License
72492 Issued in GA
Practice address
755 Walther Rd
Lawrenceville, GA 30046-8725
Phone
(770) 962-0399
NPI assigned
Mar 24, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 58874 AZ
Student in an Organized Health Care Education/Training Program 390200000X
Interventional Cardiology Physician 207RI0011X 72492 GA Primary

Addresses

Primary practice location

755 Walther Rd
Lawrenceville, GA 30046-8725

Mailing address

755 Walther Rd
Lawrenceville, GA 30046-8725
Phone (770) 962-0399

Other practice location 1

11100 Euclid Ave
University Hospitals Case Medical Center
Cleveland, OH 44106-1716
Phone (615) 891-8471

Other practice location 2

10238 E Hampton Ave
Mesa, AZ 85209-3316
Phone (480) 889-1573 ext. 48088

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA2 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
I20150903002546 GA Practitioner - Interventional CardiologyPractitioner - Internal Medicine 1153637236
I20200925000457 GA Practitioner - Internal MedicinePractitioner - Cardiovascular Disease (Cardiology)Practitioner - Interventional Cardiology 1153637236 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Interventional Cardiology
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northside CV Professional Services LLCGroup PAC ID 4880003771, 53 clinicians

Practice addresses (Care Compare)

755 Walther Rd
Lawrenceville, GA 30046-8725
Phone (678) 272-3648

Hospital & facility affiliations

  • Accentcare Home Health of Northeast Georgia Home health agency, Buford, GA, CCN 117139
  • Northside Hospital Gwinnett Hospital, Lawrenceville, GA, CCN 110087
  • Northside Hospital Duluth Hospital, Duluth, GA, CCN 110252
  • Northside Hospital Forsyth Hospital, Cumming, GA, CCN 110005
  • Piedmont Eastside Medical Center Hospital, Snellville, GA, CCN 110192

Merit-based Incentive Payment System (MIPS)

Final score
76.66 of 100Reported as group
Quality
58.46
Promoting interoperability
83
Improvement activities
40
Cost
77.92

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting62
Leg revascularization (restoring blood flow)1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
72492GAMDInterventional Cardiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Northside Hospital, Inc. CurrentSince Jun 1, 2021 Accepting new patients
Northside CV Professional Services LLC Cardiovascular Disease CurrentSince Jun 1, 2021 Accepting new patients
Northside Hospital, Inc. Past Accepting new patients

Locations

3855 Pleasant Hill Rd
Ste 250
Duluth, GA 30096
Phone (770) 497-1413

3620 Howell Ferry Rd
Duluth, GA 30096
Phone (678) 312-3294

1132 Athens Hwy
Ste 207
Grayson, GA 30017
Phone (678) 312-0300

755 Walther Rd
Lawrenceville, GA 30046

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 Ferry Rd
#R
Sandy Springs, GA 30342
Phone (404) 300-2476

1608 Tree Ln
Bldg C
Snellville, GA 30078
Phone (678) 344-4472

1120 Peachtree Industrial Blvd
Ste 208
Suwanee, GA 30024
Phone (678) 312-8400

4365 Johns Creek Pkwy
Ste 450
Suwanee, GA 30024
Phone (678) 417-9873

Organizations & group practices 3

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 5

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": "1332547200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618876800000",
    "number": "1255607255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "755 WALTHER RD",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300468725",
            "telephone_number": "770-962-0399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "755 WALTHER RD",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300468725",
            "telephone_number": "770-962-0399"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11100 Euclid Ave",
            "address_2": "University Hospitals Case Medical Center",
            "address_purpose": "LOCATION",
            "city": "Cleveland",
            "state": "OH",
            "postal_code": "441061716",
            "country_code": "US",
            "telephone_number": "615-891-8471",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "10238 E Hampton Ave",
            "address_purpose": "LOCATION",
            "city": "Mesa",
            "state": "AZ",
            "postal_code": "852093316",
            "country_code": "US",
            "telephone_number": "480-889-1573 x48088",
            "fax_number": "480-889-1574",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "THABET",
        "first_name": "SALIM",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-03-24",
        "last_updated": "2021-04-20",
        "certification_date": "2021-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "AZ",
            "license": "58874",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "GA",
            "license": "72492",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lawrenceville, GA

Sources for this page

Verify at the official NPI Registry.