Individual provider Active NPI

Ali Ahmadi, MD

  • Psychiatry Physician
  • Macon, GA
National Provider Identifier
1407993157
Registry record updated Oct 1, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
046824 Issued in GA
Practice address
3902 Northside Dr
Suite A4
Macon, GA 31210-2459
Phone
(478) 474-8774
Fax
(478) 474-8734
NPI assigned
Jan 31, 2007
Last updated
Oct 1, 2013By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 1, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 46824 GA
Psychiatry Physician 2084P0800X 046824 GA Primary

Addresses

Primary practice location

3902 Northside Dr
Suite A4
Macon, GA 31210-2459

Mailing address

3902 Northside Dr
Suite A4
Macon, GA 31210-2459
Phone (478) 474-8774

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
I20101228000272 GA Practitioner - Psychiatry 3971603580 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

3902 Northside Dr
Suite A4
Macon, GA 31210-2459
Phone (478) 474-8774

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
046824GAMDPsychiatry Physician
46824GAMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Georgia Center for Bipolar Disorder, PC Psychiatry CurrentSince Oct 19, 1999 Accepting new patients

Locations

3902 Northside Dr
Ste A4
Macon, GA 31210
Phone (478) 474-8774

754 1st St
Ste 101
Macon, GA 31201
Phone (478) 750-1313

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 1

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": "1170201600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1380585600000",
    "number": "1407993157",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3902 NORTHSIDE DR",
            "address_2": "SUITE A4",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312102459",
            "telephone_number": "478-474-8774",
            "fax_number": "478-474-8734"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3902 NORTHSIDE DR",
            "address_2": "SUITE A4",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312102459",
            "telephone_number": "478-474-8774",
            "fax_number": "478-474-8734"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AHMADI",
        "first_name": "ALI",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-31",
        "last_updated": "2013-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "GA",
            "license": "46824",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "GA",
            "license": "046824",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Macon, GA

Sources for this page

Verify at the official NPI Registry.