NPIMap

Individual provider Active NPI

Faisal Manzoor Bhutta, M.D

  • Pulmonary Disease Physician
  • Roswell, GA
National Provider Identifier
1356542856
Registry record updated Sep 26, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
069377 Issued in GA
Practice address
2500 Hospital Blvd
Suite 420
Roswell, GA 30076-4907
Phone
(770) 410-4366
Fax
(770) 410-4664
NPI assigned
May 30, 2007
Last updated
Sep 26, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pulmonary Disease Physician 207RP1001X 069377 GA Primary

Addresses

Primary practice location

2500 Hospital Blvd
Suite 420
Roswell, GA 30076-4907

Mailing address

P.O. Box 742342
Atlanta, GA 30374-2342
Phone (770) 410-4366

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address fbhutta123285@directwellstar.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130701000273 GA Practitioner - Pulmonary DiseasePractitioner - Critical Care (Intensivists) 8426111519 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pulmonary DiseaseAlso: Critical Care (Intensivists)
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Wellstar Medical Group LLCGroup PAC ID 6709065402, 3,059 clinicians

Practice addresses (Care Compare)

2500 Hospital Blvd
Suite 110
Roswell, GA 30076-4946
Phone (770) 410-4366

3000 Hospital Blvd
Roswell, GA 30076-4915
Phone (770) 751-2912

5150 Stilesboro N W Rd
Suite 220
Kennesaw, GA 30152-7742
Phone (770) 424-8222

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.93 of 100Reported as apm
Quality
82.14
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
069377GAMDPulmonary Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wellstar Medical Group, LLC CurrentSince Apr 1, 2016 Accepting new patients
Wellstar Medical Group, LLC CurrentSince Apr 1, 2016 Accepting new patients
Wellstar Medical Group, LLC Current Accepting new patients
Allergy Associates, P.a. Past Accepting new patients
North Fulton Pulmonary Specialists, LLC Pulmonary Disease Past Accepting new patients
Lancaster Hma Physician Management, LLC Pulmonary Disease Past Accepting new patients

Locations

5150 Stilesboro Rd NW
Ste 120
Kennesaw, GA 30152
Phone (678) 354-0230

5150 Stilesboro Rd NW
Ste 220
Kennesaw, GA 30152
Phone (770) 424-8222

805 Sandy Plains Rd
Marietta, GA 30066
Phone (770) 792-1616

2500 Hospital Blvd
Ste 420
Roswell, GA 30076
Phone (770) 410-4366

Interoperability endpoints

  • Direct secure messaging: faisal.bhutta.p115@direct.tenet.nextgenshare.com
  • Direct secure messaging: fbhutta123285@directwellstar.org

Organizations & group practices 6

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": "1180483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569456000000",
    "number": "1356542856",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 742342",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303742342",
            "telephone_number": "770-410-4366",
            "fax_number": "770-410-4664"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 HOSPITAL BLVD",
            "address_2": "SUITE 420",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "300764907",
            "telephone_number": "770-410-4366",
            "fax_number": "770-410-4664"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BHUTTA",
        "first_name": "FAISAL",
        "middle_name": "MANZOOR",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-30",
        "last_updated": "2019-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "GA",
            "license": "069377",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "fbhutta123285@directwellstar.org",
            "affiliation": "N",
            "address_1": "2500 Hospital Blvd",
            "address_2": "Suite 420",
            "city": "Roswell",
            "state": "GA",
            "country_code": "US",
            "postal_code": "300764907",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Roswell, GA

Sources for this page

Verify at the official NPI Registry.