Active NPI
Imran Hasan Iftikhar, M.D.
- Pulmonary Disease Physician
- Atlanta, GA
National Provider Identifier
1295988988
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pulmonary Disease Physician
- License
- 075447
- Practice address
- 5665 Peachtree Dunwoody Rd
Atlanta, GA 30342-1764 - Phone
- (678) 843-7001
- NPI assigned
- Oct 28, 2008
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 6
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Sleep Medicine (Internal Medicine) Physician | 207RS0012X | 30579 | SC | |
| Pulmonary Disease Physician | 207RP1001X | 30579 | SC | |
| Sleep Medicine (Internal Medicine) Physician | 207RS0012X | 57 | OH | |
| Internal Medicine Physician | 207R00000X | 30579 | SC | |
| Pulmonary Disease Physician | 207RP1001X | 075447 | GA | Primary |
| Pulmonary Disease Physician | 207RP1001X | 35125869 | OH |
Addresses
Primary practice location
5665 Peachtree Dunwoody Rd
Atlanta, GA 30342-1764
Mailing address
5665 Peachtree Dunwoody Rd
Atlanta, GA 30342-1764
Phone (678) 843-7001
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 305798 | Medicaid | SC | |
| AA69022603 | Other | SC | MEDICARE PTAN |
| PENDING | Medicaid | OH |
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 35125869 | OH | MD | Pulmonary Disease Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Emory Clinic Inc | Internal Medicine | Current | Accepting new patients |
Locations
1365 Clifton Rd NE
Atlanta, GA 30322
Phone (404) 778-7525
101 W Ponce de Leon Ave
Decatur, GA 30030
Phone (404) 778-4889
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.
-
- Internal Medicine Physician
- Atlanta, GA
- NPI 1396798229
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1225152000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1464134400000",
"number": "1295988988",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5665 PEACHTREE DUNWOODY RD",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303421764",
"telephone_number": "678-843-7001"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5665 PEACHTREE DUNWOODY RD",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303421764",
"telephone_number": "678-843-7001"
}
],
"practiceLocations": [],
"basic": {
"last_name": "IFTIKHAR",
"first_name": "IMRAN",
"middle_name": "HASAN",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-10-28",
"last_updated": "2016-05-25",
"status": "A"
},
"taxonomies": [
{
"code": "207RS0012X",
"taxonomy_group": "",
"desc": "Internal Medicine, Sleep Medicine",
"state": "SC",
"license": "30579",
"primary": false
},
{
"code": "207RP1001X",
"taxonomy_group": "",
"desc": "Internal Medicine, Pulmonary Disease",
"state": "SC",
"license": "30579",
"primary": false
},
{
"code": "207RS0012X",
"taxonomy_group": "",
"desc": "Internal Medicine, Sleep Medicine",
"state": "OH",
"license": "57",
"primary": false
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "SC",
"license": "30579",
"primary": false
},
{
"code": "207RP1001X",
"taxonomy_group": "",
"desc": "Internal Medicine, Pulmonary Disease",
"state": "GA",
"license": "075447",
"primary": true
},
{
"code": "207RP1001X",
"taxonomy_group": "",
"desc": "Internal Medicine, Pulmonary Disease",
"state": "OH",
"license": "35125869",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "305798",
"state": "SC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE PTAN",
"identifier": "AA69022603",
"state": "SC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "PENDING",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Atlanta, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.