Individual provider Active NPI

Mitchell Wayne Hecht, M.D.

  • Internal Medicine Physician
  • Roswell, GA
National Provider Identifier
1265434294
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
040405 Issued in GA
Practice address
2500 Hospital Blvd
Suite 280
Roswell, GA 30076-4907
Phone
(770) 475-0212
Fax
(770) 410-0006
NPI assigned
Aug 10, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 040405 GA Primary

Addresses

Primary practice location

2500 Hospital Blvd
Suite 280
Roswell, GA 30076-4907

Mailing address

2500 Hospital Blvd
Suite 280
Roswell, GA 30076-4907
Phone (770) 475-0212

Other identifiers 1

IdentifierTypeStateIssuer
00697012CMedicaidGA

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
I20080826000073 GA Practitioner - Internal Medicine 3072688076 Practice locations: Roswell, GA

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Saint Louis University School of Medicine, 1990
Medicare assignment
May accept Medicare assignment
Group practices
Select Rehabilitation, LLCGroup PAC ID 9032020490, 1,935 clinicians

Practice addresses (Care Compare)

1305 Hembree Rd
Suite 201
Roswell, GA 30076-3810
Phone (770) 475-0212

2600 Compass Rd
Glenview, IL 60026-8001

Hospital & facility affiliations

National Provider Directory

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

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 7

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": "1123632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1265434294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 HOSPITAL BLVD",
            "address_2": "SUITE 280",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "300764907",
            "telephone_number": "770-475-0212",
            "fax_number": "770-410-0006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 HOSPITAL BLVD",
            "address_2": "SUITE 280",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "300764907",
            "telephone_number": "770-475-0212",
            "fax_number": "770-410-0006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HECHT",
        "first_name": "MITCHELL",
        "middle_name": "WAYNE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "040405",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00697012C",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Roswell, GA

Sources for this page

Verify at the official NPI Registry.