Individual provider Active NPI

Mohammed R Ahmeduddin, DPM

  • Podiatrist
  • Lawrenceville, GA
National Provider Identifier
1295998722
Registry record updated Apr 20, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
POD001431 Issued in GA
Practice address
980 Lawrenceville Hwy
Lawrenceville, GA 30046-4706
Phone
(770) 266-0935
NPI assigned
Jul 3, 2008
Last updated
Apr 20, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 20, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X E4653 CA
Podiatrist 213E00000X POD001431 GA Primary

Addresses

Primary practice location

980 Lawrenceville Hwy
Lawrenceville, GA 30046-4706

Mailing address

1395 NW 167TH St
Miami, FL 33169-5710
Phone (305) 628-6117

Other practice location 1

240 S La Cienega Blvd
Suite 300
Beverly Hills, CA 90211-3324
Phone (310) 652-3668

Other practice location 2

2124 Candler Rd
Decatur, GA 30032
Phone (404) 836-0272

Other practice location 3

240 S La Cienega Blvd
Suite 300
Beverly Hills, CA 90211-3324
Phone (310) 652-3668

Other identifiers 1

IdentifierTypeStateIssuer
200982210MedicaidIN

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191015000489 GA Practitioner - Podiatry 8820014400 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Kent State University College of Podiatric Medicine, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Medlink Georgia IncGroup PAC ID 3274442850, 93 clinicians

Practice addresses (Care Compare)

11 Charlie Morris Rd
Colbert, GA 30628-2445
Phone (706) 788-2127

133 W Athens St
Winder, GA 30680-1786
Phone (770) 867-6633

137 W Athens St
Winder, GA 30680-1786
Phone (770) 867-6633

980 Lawrenceville Hwy
Lawrenceville, GA 30046-4706
Phone (770) 676-6500

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal of nail tissue1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
POD001431GAMDPodiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Medlink Georgia Inc Podiatrist CurrentSince Sep 8, 2025 Accepting new patients
Medlink Georgia, Inc CurrentSince Sep 8, 2025 Accepting new patients
David Dardashti DPM a Professional Corporation Past Accepting new patients
Jencare Neighborhood Medical Center West End, LLC PastSince Aug 4, 2014 Accepting new patients
Mohammed Ahmeduddin, LLC Past Accepting new patients
Medlink Georgia Inc Past Accepting new patients

Locations

11 Charlie Morris Rd
Colbert, GA 30628
Phone (706) 738-3234

11 Charlie Morris Rd
Bldg 2
Colbert, GA 30628
Phone (706) 738-3234

980 Lawrenceville Hwy
Lawrenceville, GA 30046
Phone (770) 676-6500

133 W Athens St
Winder, GA 30680
Phone (770) 867-6633

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1215043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776643200000",
    "number": "1295998722",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1395 NW 167TH ST",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331695710",
            "telephone_number": "305-628-6117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "980 LAWRENCEVILLE HWY",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300464706",
            "telephone_number": "770-266-0935"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "240 S La Cienega Blvd",
            "address_2": "Suite 300",
            "address_purpose": "LOCATION",
            "city": "Beverly Hills",
            "state": "CA",
            "postal_code": "902113324",
            "country_code": "US",
            "telephone_number": "310-652-3668",
            "fax_number": "310-652-3669",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2124 Candler Rd",
            "address_purpose": "LOCATION",
            "city": "Decatur",
            "state": "GA",
            "postal_code": "30032",
            "country_code": "US",
            "telephone_number": "404-836-0272",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "240 S La Cienega Blvd",
            "address_2": "Suite 300",
            "address_purpose": "LOCATION",
            "city": "Beverly Hills",
            "state": "CA",
            "postal_code": "902113324",
            "country_code": "US",
            "telephone_number": "310-652-3668",
            "fax_number": "310-652-3669",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AHMEDUDDIN",
        "first_name": "MOHAMMED",
        "middle_name": "R",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-07-03",
        "last_updated": "2026-04-20",
        "certification_date": "2026-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "CA",
            "license": "E4653",
            "primary": false
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "GA",
            "license": "POD001431",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200982210",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lawrenceville, GA

Sources for this page

Verify at the official NPI Registry.