Individual provider Active NPI

Omar Rafik Kashlan, M.D.

  • Interventional Cardiology Physician
  • Snellville, GA
National Provider Identifier
1346410594
Registry record updated Nov 30, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Cardiology PhysicianTaxonomy code 207RI0011X
License
75729 Issued in GA
Practice address
1700 Tree LN Ste 190
Snellville, GA 30078-6766
Phone
(770) 736-6300
NPI assigned
Mar 4, 2008
Last updated
Nov 30, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 4301096318 MI
Interventional Cardiology Physician 207RI0011X 75729 GA Primary

Addresses

Primary practice location

1700 Tree LN Ste 190
Snellville, GA 30078-6766

Mailing address

229 Peachtree St NE Ste 1200
Atlanta, GA 30303-1620
Phone (404) 874-1788

Other practice location 1

2222 S Linden Rd
Ste A
Flint, MI 48532-5475
Phone (810) 733-0790

Other practice location 2

2222 S Linden Rd
Ste A
Flint, MI 48532-5475
Phone (810) 733-0790

Other practice location 3

229 Peachtree St NE Ste 1200
Atlanta, GA 30303
Phone (404) 874-1788

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address okashlan175497@directwellstar.org

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
I20180917001218 GA Practitioner - Interventional CardiologyPractitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 9830321207 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Interventional CardiologyAlso: Cardiovascular Disease (Cardiology)
Education
Morehouse School of Medicine, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Piedmont Cardiology of Atlanta, LLCGroup PAC ID 0345321691, 478 clinicians

Practice addresses (Care Compare)

1700 Tree LN
Suite 190
Snellville, GA 30078-6766
Phone (770) 366-6300

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
91.62 of 100Reported as apm
Quality
83.25
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
75729GAMDInterventional Cardiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Piedmont Cardiology of Atlanta, LLC Cardiovascular Disease CurrentSince Dec 19, 2022 Accepting new patients

Locations

1412 Milstead Ave NE
Conyers, GA 30012
Phone (770) 918-3000

1700 Tree Ln
Ste 190
Snellville, GA 30078
Phone (404) 805-9991

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

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": "1204588800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669766400000",
    "number": "1346410594",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "229 PEACHTREE ST NE STE 1200",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303031620",
            "telephone_number": "404-874-1788",
            "fax_number": "404-872-4589"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 TREE LN STE 190",
            "city": "SNELLVILLE",
            "state": "GA",
            "postal_code": "300786766",
            "telephone_number": "770-736-6300"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2222 S Linden Rd",
            "address_2": "Ste A",
            "address_purpose": "LOCATION",
            "city": "Flint",
            "state": "MI",
            "postal_code": "485325475",
            "country_code": "US",
            "telephone_number": "810-733-0790",
            "fax_number": "810-733-0235",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2222 S Linden Rd",
            "address_2": "Ste A",
            "address_purpose": "LOCATION",
            "city": "Flint",
            "state": "MI",
            "postal_code": "485325475",
            "country_code": "US",
            "telephone_number": "810-733-0790",
            "fax_number": "810-733-0235",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "229 Peachtree St NE Ste 1200",
            "address_purpose": "LOCATION",
            "city": "Atlanta",
            "state": "GA",
            "postal_code": "30303",
            "country_code": "US",
            "telephone_number": "404-874-1788",
            "fax_number": "404-872-4589",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KASHLAN",
        "first_name": "OMAR",
        "middle_name": "RAFIK",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-03-04",
        "last_updated": "2022-11-30",
        "certification_date": "2022-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "MI",
            "license": "4301096318",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "GA",
            "license": "75729",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "okashlan175497@directwellstar.org",
            "affiliation": "N",
            "address_1": "229 Peachtree St NE Ste 1200",
            "city": "Atlanta",
            "state": "GA",
            "country_code": "US",
            "postal_code": "303031620",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Snellville, GA

Sources for this page

Verify at the official NPI Registry.