Individual provider Active NPI

Amita Shroff, MD

  • Pediatric Emergency Medicine (Pediatrics) Physician
  • Atlanta, GA
National Provider Identifier
1265608681
Registry record updated Mar 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Emergency Medicine (Pediatrics) PhysicianTaxonomy code 2080P0204X
License
60613 Issued in GA
Practice address
1405 Clifton Rd NE
Atlanta, GA 30322-7694
Phone
(404) 785-3655
NPI assigned
May 6, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 31, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 60613 GA
Pediatric Emergency Medicine (Pediatrics) Physician 2080P0204X 60613 GA Primary

Addresses

Primary practice location

1405 Clifton Rd NE
Atlanta, GA 30322-7694

Mailing address

1813 Buckhead Valley LN NE
Atlanta, GA 30324-2796
Phone (917) 915-1097

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
I20090311000170 GA Practitioner - Emergency MedicinePractitioner - Pediatric Medicine 9537225842 Reassigns benefits to 4 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
60613GAMDPediatric Emergency Medicine (Pediatrics) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Emory Medical Care Foundation Inc CurrentSince Dec 9, 2024 Accepting new patients
Emergency Group of Columbus, LLC CurrentSince Aug 1, 2018 Accepting new patients
Northside Emergency Associates, LLC CurrentSince Mar 20, 2020 Accepting new patients
Emory Medical Care Foundation Inc Current Accepting new patients
Emory Medical Care Foundation Inc Pediatrics CurrentSince Dec 9, 2024 Accepting new patients

Locations

80 Jesse Hill Jr Dr SE
Atlanta, GA 30303
Phone (404) 616-4370

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

710 Center St
Columbus, GA 31901
Phone (706) 571-1000

1000 Johnson Ferry Rd
Sandy Springs, GA 30342
Phone (404) 851-8737

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/14272/brand/70/csg/1/fhir/r4
  • Direct secure messaging: ashroff12929@choa.gadirect.net

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1210032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711843200000",
    "number": "1265608681",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1813 BUCKHEAD VALLEY LN NE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303242796",
            "telephone_number": "917-915-1097"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1405 CLIFTON RD NE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303227694",
            "telephone_number": "404-785-3655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHROFF",
        "first_name": "AMITA",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-05-06",
        "last_updated": "2024-03-31",
        "certification_date": "2024-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "GA",
            "license": "60613",
            "primary": false
        },
        {
            "code": "2080P0204X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Emergency Medicine",
            "state": "GA",
            "license": "60613",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.