Individual provider Active NPI

Sohail A Choudhri, M.D.

  • Gastroenterology Physician
  • Waycross, GA
National Provider Identifier
1407960289
Registry record updated Jan 2, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
036514 Issued in GA
Practice address
1501 Alice St
Waycross, GA 31501-4530
Phone
(912) 285-0877
Fax
(912) 287-0387
NPI assigned
Aug 18, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 2, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 036514 GA Primary

Addresses

Primary practice location

1501 Alice St
Waycross, GA 31501-4530

Mailing address

1501 Alice St
Waycross, GA 31501-4530
Phone (912) 285-0877

Other identifiers 1

IdentifierTypeStateIssuer
00539459AMedicaidGA

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
I20080528000116 GA Practitioner - Gastroenterology 5991748717 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
Other, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Digestive Disease Consultants, P.C.Group PAC ID 8729021548, 2 clinicians

Practice addresses (Care Compare)

1501 Alice St
Waycross, GA 31501-4530
Phone (912) 285-0877

Hospital & facility affiliations

  • Memorial Satilla Health Hospital, Waycross, GA, CCN 110003
  • Bacon County Hospital Hospital, Alma, GA, CCN 111327
  • Southeast Georgia Health System- Brunswick Campus Hospital, Brunswick, GA, CCN 110025
  • Wayne Memorial Hospital Hospital, Jesup, GA, CCN 110124

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy409
Upper gastrointestinal (GI) endoscopy for acid reflux333

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Digestive Disease Consultants, P.C. Gastroenterology CurrentSince Jul 1, 1990 Accepting new patients
South Georgia Endoscopy Center, Inc PastSince Jun 6, 2008 Accepting new patients
Okefenokee Anesthesia Company LLC PastSince Nov 7, 2012 Accepting new patients

Locations

1501 Alice St
Waycross, GA 31501
Phone (844) 469-4936

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/CAFBBA

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 and National Provider Directory roles.

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": "1155859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1357084800000",
    "number": "1407960289",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1501 ALICE ST",
            "city": "WAYCROSS",
            "state": "GA",
            "postal_code": "315014530",
            "telephone_number": "912-285-0877",
            "fax_number": "912-287-0387"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 ALICE ST",
            "city": "WAYCROSS",
            "state": "GA",
            "postal_code": "315014530",
            "telephone_number": "912-285-0877",
            "fax_number": "912-287-0387"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHOUDHRI",
        "first_name": "SOHAIL",
        "middle_name": "A",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-18",
        "last_updated": "2013-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "GA",
            "license": "036514",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00539459A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Waycross, GA

Sources for this page

Verify at the official NPI Registry.