NPIMap

Individual provider Active NPI

Michel Brathwaite, MD

  • Nephrology Physician
  • Atlanta, GA
National Provider Identifier
1295723492
Registry record updated Dec 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
038694 Issued in GA
Practice address
3620 Martin Luther King Jr Dr SW
Atlanta, GA 30331-3711
Phone
(404) 696-7300
Fax
(404) 699-3514
NPI assigned
Oct 11, 2005
Last updated
Dec 16, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X 038694 GA Primary

Addresses

Primary practice location

3620 Martin Luther King Jr Dr SW
Atlanta, GA 30331-3711

Mailing address

3620 Martin Luther King Jr Dr SW
Atlanta, GA 30331-3711
Phone (404) 696-7300

Other identifiers 12

IdentifierTypeStateIssuer
000618076KMedicaidGA
000618076NMedicaidGA
726082OtherGACIGNA
000618076FMedicaidGA
000618076AMedicaidGA
110091303OtherGARAILROAD MEDICARE
506853OtherGABCBS
000618076MMedicaidGA
000618076CMedicaidGA
3120000OtherGAUNITED HEALTH CARE
000618076HMedicaidGA
505411OtherGAAETNA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050125000461 GA Practitioner - Nephrology 1850294893 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nephrology
Education
Temple University School of Medicine, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Southwest Atlanta Nephrology, PCGroup PAC ID 2062315088, 9 clinicians

Practice addresses (Care Compare)

3620 Martin Luther King Jr Dr SW
Atlanta, GA 30331-3711
Phone (404) 696-7300

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Southwest Atlanta Nephrology, PC Nephrology CurrentSince Jul 1, 1994 Accepting new patients
Morehouse Healthcare, Inc. Nephrology PastSince Jul 1, 2012 Accepting new patients

Locations

3620 Martin Luther King Jr Dr SW
Atlanta, GA 30331
Phone (404) 696-7300

2669 Church St
East Point, GA 30344
Phone (404) 209-0113

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/16547/brand/1/csg/1/fhir/r4
  • Direct secure messaging: michel.brathwaite.1@16547.direct.athenahealth.com

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 8

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": "1128988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608076800000",
    "number": "1295723492",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3620 MARTIN LUTHER KING JR DR SW",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303313711",
            "telephone_number": "404-696-7300",
            "fax_number": "404-699-3514"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3620 MARTIN LUTHER KING JR DR SW",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303313711",
            "telephone_number": "404-696-7300",
            "fax_number": "404-699-3514"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRATHWAITE",
        "first_name": "MICHEL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-11",
        "last_updated": "2020-12-16",
        "certification_date": "2020-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "GA",
            "license": "038694",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000618076K",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000618076N",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "726082",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000618076F",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000618076A",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "110091303",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "506853",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000618076M",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000618076C",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTH CARE",
            "identifier": "3120000",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000618076H",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "505411",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.