Active NPI
Mary John Ninan, M.D
- Hematology & Oncology Physician
- Johns Creek, GA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Hematology & Oncology Physician
- License
- 058551
- Practice address
- 6300 Hospital Pkwy Ste 300
Johns Creek, GA 30097-1982 - Phone
- (770) 623-8965
- Fax
- (770) 623-4018
- NPI assigned
- Aug 15, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Hematology & Oncology Physician | 207RH0003X | 058551 | GA | Primary |
| Hematology & Oncology Physician | 207RH0003X | 43128 | TX | |
| Hematology & Oncology Physician | 207RH0003X | N7955 | TX |
Addresses
Primary practice location
6300 Hospital Pkwy Ste 300
Johns Creek, GA 30097-1982
Mailing address
1835 Savoy Dr Ste 300
Atlanta, GA 30341-1071
Phone (678) 566-6995
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| G10127A | Other | GA | MEDICARE PTAN |
| 003158193C | Medicaid | GA | |
| 003158193D | Medicaid | GA |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | mary.ninan.p1@direct.gacancer.nextgenshare.com | Direct |
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
Care Compare profile
Medicare Care Compare- Specialty
- Medical Oncology
- Education
- Other, 1999
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
6300 Hospital Pkwy
Suite 300
Duluth, GA 30097-1982
Phone (770) 623-8965
Hospital & facility affiliations
- Northside Hospital
- Northside Hospital Forsyth
- Northside Hospital Cherokee
- Northside Hospital Duluth
Merit-based Incentive Payment System (MIPS)
- Final score
- 71.19 of 100
- Quality
- 69.24
- Improvement activities
- 40
- Cost
- 51.37
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| N7955 | TX | MD | Hematology & Oncology Physician |
| 43128 | TX | MD | Speech-Language Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| City of Hope Medical Group of Georgia LLC | Current | Accepting new patients | |
| NSH Cancer Institute Professional Services G, LLC | Hematology & Oncology | Current | Accepting new patients |
| NSH Cancer Institute Professional Services G LLC | Current | Accepting new patients | |
| NSH Cancer Institute Professional Services G, LLC | Hematology & Oncology | Past | Accepting new patients |
| Northside Imaging LLC | Past | Accepting new patients |
Locations
3330 Preston Ridge Rd
Ste 110
Alpharetta, GA 30005
Phone (678) 566-6995
1835 Savoy Dr
Ste 300
Atlanta, GA 30341
Phone (678) 288-9555
6300 Hospital Pkwy
Ste 300
Johns Creek, GA 30097
Phone (770) 623-8965
600 Celebrate Life Pkwy
Newnan, GA 30265
Phone (404) 844-8334
1045 Southcrest Dr
Ste 200
Stockbridge, GA 30281
Phone (678) 289-0549
62742 Collections Ctr Dr
Chicago, IL 60693
Interoperability endpoints
- mary.ninan.p1@direct.gacancer.nextgenshare.com
Organizations & group practices 5
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.
-
- Hematology & Oncology Physician
- Sandy Springs, GA
- NPI 1144571381
-
- Internal Medicine Physician
- Newnan, GA
- NPI 1447520333
-
- Durable Medical Equipment & Medical Supplies
- Blue Ridge, GA
- NPI 1629329792
-
- Diagnostic Radiology Physician
- Warner Robins, GA
- NPI 1316394976
-
- Hematology & Oncology Physician
- Atlanta, GA
- NPI 1124379284
Hospital & facility affiliations 4
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Canton, GA
- NPI 1225050396
-
- General Acute Care Hospital
- Cumming, GA
- NPI 1376574277
-
- General Acute Care Hospital
- Atlanta, GA
- NPI 1457396079
-
- General Acute Care Hospital
- Duluth, GA
- NPI 1790715381
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1187136000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1597881600000",
"number": "1356533145",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1835 SAVOY DR STE 300",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303411071",
"telephone_number": "678-566-6995",
"fax_number": "678-566-0346"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6300 HOSPITAL PKWY STE 300",
"city": "JOHNS CREEK",
"state": "GA",
"postal_code": "300971982",
"telephone_number": "770-623-8965",
"fax_number": "770-623-4018"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NINAN",
"first_name": "MARY",
"middle_name": "JOHN",
"name_prefix": "Dr.",
"credential": "M.D",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-08-15",
"last_updated": "2020-08-20",
"certification_date": "2020-08-20",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "207RH0003X",
"taxonomy_group": "",
"desc": "Internal Medicine, Hematology & Oncology",
"state": "GA",
"license": "058551",
"primary": true
},
{
"code": "207RH0003X",
"taxonomy_group": "",
"desc": "Internal Medicine, Hematology & Oncology",
"state": "TX",
"license": "43128",
"primary": false
},
{
"code": "207RH0003X",
"taxonomy_group": "",
"desc": "Internal Medicine, Hematology & Oncology",
"state": "TX",
"license": "N7955",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE PTAN",
"identifier": "G10127A",
"state": "GA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "003158193C",
"state": "GA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "003158193D",
"state": "GA"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "mary.ninan.p1@direct.gacancer.nextgenshare.com",
"affiliation": "N",
"endpointDescription": "Direct Address",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "Direct Edge",
"address_1": "6300 Hospital Pkwy Ste 300",
"city": "Johns Creek",
"state": "GA",
"country_code": "US",
"postal_code": "300971982",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Johns Creek, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2020; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.