NPIMap

Organization Active NPI

Elite Radiology of Georgia, LLC

  • Diagnostic Radiology Physician
  • Atlanta, GA
National Provider Identifier
1346608239
Registry record updated Feb 5, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
69574 Issued in GA
Legal business name
ELITE RADIOLOGY OF GEORGIA, LLC
Practice address
4800 Ashford Dunwoody Rd
Suite 140
Atlanta, GA 30338-4897
Phone
(404) 419-2058
Fax
(404) 381-8263
NPI assigned
Feb 5, 2016
Last updated
Feb 5, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2016

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

Authorized official

Name
Dr. Chintan Desai, M.DNPI 1194819441
Title
Owner
Phone
(813) 463-4442

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2085R0202X 69574 GA Primary

Addresses

Primary practice location

4800 Ashford Dunwoody Rd
Suite 140
Atlanta, GA 30338-4897

Mailing address

607 W MLK Blvd
Suite 103
Tampa, FL 33603-3453
Phone (813) 238-3833

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, FL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20160512002411 GA Part B Supplier - Clinic/Group Practice 8527357656 Receives reassigned benefits from 5 practitioners
Practice locations: Lithia Springs, GA; Stockbridge, GA; Marietta, GA; Decatur, GA; Duluth, GA
O20251103001707 FL Part B Supplier - Clinic/Group Practice 8527357656 Receives reassigned benefits from 2 practitioners
Practice locations: Coral Gables, FL; Tampa, FL

National Provider Directory

National Provider Directory

Locations

4800 Ashford Dunwoody Rd
Atlanta, GA 30338
Phone (404) 419-2058

4800 Ashford Dunwoody Rd
Ste 140
Atlanta, GA 30338
Phone (404) 419-2058

1458 Church St
Ste D
Decatur, GA 30030
Phone (404) 419-2058

2623 N Decatur Rd
Decatur, GA 30033

3547 Peachtree Industrial Blvd
Duluth, GA 30096
Phone (312) 929-8662

939 Bob Arnold Blvd
Ste C
Lithia Springs, GA 30122
Phone (404) 946-2885

3547 Peachtree Ind Blvd
Marietta, GA 30069

790 Church St NE
Ste 105
Marietta, GA 30060
Phone (470) 462-0134

1040 Eagles Landing Pkwy
Ste 102
Stockbridge, GA 30281
Phone (404) 419-2058

Practitioners & affiliated clinicians

Practitioners 16

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1454630400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1454630400000",
    "number": "1346608239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "607 W MLK BLVD",
            "address_2": "SUITE 103",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336033453",
            "telephone_number": "813-238-3833",
            "fax_number": "813-849-6349"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4800 ASHFORD DUNWOODY RD",
            "address_2": "SUITE 140",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303384897",
            "telephone_number": "404-419-2058",
            "fax_number": "404-381-8263"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELITE RADIOLOGY OF GEORGIA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-02-05",
        "last_updated": "2016-02-05",
        "status": "A",
        "authorized_official_last_name": "DESAI",
        "authorized_official_first_name": "CHINTAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "813-463-4442",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "GA",
            "license": "69574",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Feb 5, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.