Individual provider Active NPI

Nesrudin Ibrahim Hamid

  • Hospitalist Physician
  • Atlanta, GA
National Provider Identifier
1265604136
Registry record updated Feb 8, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
062885 Issued in GA
Practice address
35 Collier Rd NW
Suite 635
Atlanta, GA 30309-1613
Phone
(404) 367-3014
Fax
(404) 367-3558
NPI assigned
Mar 31, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 8, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 062885 GA
Hospitalist Physician 208M00000X 062885 GA Primary

Addresses

Primary practice location

35 Collier Rd NW
Suite 635
Atlanta, GA 30309-1613

Mailing address

PO Box 102321
Atlanta, GA 30368-2321

Other identifiers 2

IdentifierTypeStateIssuer
202I113887OtherGAMEDICARE
775661638MedicaidGA

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
I20090922000170 GA Practitioner - Internal Medicine 3274689948 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Piedmont Hospitalist Physicians LLCGroup PAC ID 1951299163, 503 clinicians

Practice addresses (Care Compare)

35 Collier Rd NW
Suite 635
Atlanta, GA 30309-1611
Phone (404) 367-3000

Hospital & facility affiliations

  • Interim Healthcare of Atlanta Inc Home health agency, Atlanta, GA, CCN 117067
  • Piedmont Hospital, Inc Hospital, Atlanta, GA, CCN 110083
  • Piedmont Mountainside Hospital Inc Hospital, Jasper, GA, CCN 110225

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
062885GAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
24 On Physicians, PC Hospitalist CurrentSince Oct 1, 2013 Accepting new patients
24 On Physicians, P.C. Hospitalist CurrentSince Oct 1, 2013 Accepting new patients
Piedmont Hospital, Inc Past Accepting new patients

Locations

13000 Deerfield Pkwy
Ste 100
Alpharetta, GA 30004

1412 Milstead Ave NE
Conyers, GA 30012
Phone (770) 918-3000

304 Turner McCall Blvd SW
Rome, GA 30165
Phone (706) 506-5000

2801 DeKalb Medical Pkwy
Stonecrest, GA 30058
Phone (404) 501-5374

Organizations & group practices 4

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 3

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": "1206921600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1297123200000",
    "number": "1265604136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 102321",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303682321"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "35 COLLIER RD NW",
            "address_2": "SUITE 635",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303091613",
            "telephone_number": "404-367-3014",
            "fax_number": "404-367-3558"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAMID",
        "first_name": "NESRUDIN",
        "middle_name": "IBRAHIM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-03-31",
        "last_updated": "2011-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "062885",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "GA",
            "license": "062885",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "202I113887",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "775661638",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.