Individual provider Active NPI

Elan J Golan, M.D.

  • Sports Medicine (Orthopaedic Surgery) Physician
  • Snellville, GA
National Provider Identifier
1306102785
Registry record updated Dec 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Orthopaedic Surgery) PhysicianTaxonomy code 207XX0005X
License
83600 Issued in GA
Practice address
2220 Wisteria Dr Ste 202
Snellville, GA 30078-4604
Phone
(678) 344-4944
Fax
(678) 344-4947
NPI assigned
Apr 10, 2012
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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Sports Medicine (Orthopaedic Surgery) Physician 207XX0005X 83600 GA Primary

Addresses

Primary practice location

2220 Wisteria Dr Ste 202
Snellville, GA 30078-4604

Mailing address

2220 Wisteria Dr Ste 202
Snellville, GA 30078-4604
Phone (678) 344-4944

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
I20191120003351 GA Practitioner - Orthopedic SurgeryPractitioner - Sports Medicine 0547511735 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic SurgeryAlso: Sports Medicine
Education
George Washington University School of Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sports Medicine South of Gwinnett LLCGroup PAC ID 9335566967, 14 clinicians
Northside Surgical Professional Services LLCGroup PAC ID 8628253424, 367 clinicians
Physiotherapy Associates IncGroup PAC ID 3577470442, shared by 50 NPIs, 1,432 clinicians

Practice addresses (Care Compare)

1900 Riverside Pkwy
Lawrenceville, GA 30043-5925
Phone (770) 237-3475

2306 Wisteria Dr
Suite 100
Snellville, GA 30078-2658
Phone (770) 979-8200

3605 Braselton Hwy
Suite 101
Dacula, GA 30019-4666
Phone (770) 904-0772

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Upper limb (arm) arthroscopy (minimally invasive joint repair)32

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Sports Medicine South of Gwinnett LLC Sports Medicine CurrentSince Jul 1, 2022 Accepting new patients
Gwinnett Medical Group, Inc Past Accepting new patients

Locations

2069 Teron Trce
Ste 300
Dacula, GA 30019
Phone (678) 541-2001

1900 Riverside Pkwy
Lawrenceville, GA 30043
Phone (770) 237-3475

2220 Wisteria Dr
Ste 202
Snellville, GA 30078
Phone (678) 344-4944

2306 Wisteria Dr
Ste 100
Snellville, GA 30078
Phone (770) 979-8200

2306 Wisteria Dr
Ste 240
Snellville, GA 30078
Phone (678) 344-4944

Organizations & group practices 3

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 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": "1334016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608076800000",
    "number": "1306102785",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2220 WISTERIA DR STE 202",
            "city": "SNELLVILLE",
            "state": "GA",
            "postal_code": "300784604",
            "telephone_number": "678-344-4944"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2220 WISTERIA DR STE 202",
            "city": "SNELLVILLE",
            "state": "GA",
            "postal_code": "300784604",
            "telephone_number": "678-344-4944",
            "fax_number": "678-344-4947"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLAN",
        "first_name": "ELAN",
        "middle_name": "J",
        "name_prefix": "Mr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-04-10",
        "last_updated": "2020-12-16",
        "certification_date": "2020-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "GA",
            "license": "83600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Snellville, GA

Sources for this page

Verify at the official NPI Registry.