Ali Ahmadi, MD
Individual provider Active NPI Psychiatry Physician · Macon, GA
NPI 1407993157 · NPPES record last updated Oct 1, 2013
Key facts
- NPI
- 1407993157
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychiatry Physician 2084P0800X
- License
- 046824 (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
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Hospital & facility affiliations 1
Medicare Care Compare profile
- 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
- Atrium Health Navicent the Medical Center
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in GA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20101228000272 | GA | Practitioner - Psychiatry | 3971603580 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 046824 | GA | MD | Psychiatry Physician |
| 46824 | GA | MD | Psychiatry Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Georgia Center for Bipolar Disorder, PC | Psychiatry | Current |
Accepting new patients |
Locations
754 1st St
Ste 101
Macon, GA 31201
Phone (478) 750-1313
3902 Northside Dr
Ste A4
Macon, GA 31210
Phone (478) 474-8774
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 46824 | GA | |
| Psychiatry Physician | 2084P0800X | 046824 | GA | Yes |
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
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00832378C | Medicaid | GA |
Other providers in Macon, GA
- Arvind Kumar Aggarwal
- Korie L Agudelo
- William Enrique Agudelo
- Ikechukwu Chukwudi Agulonu
- Omar Faruk Ahmad
- Aftab Ahmed
- Saghir Ahmed
- Weaam Ahmed
- Umme Salma Ahsan
- Aica Clinics - Macon PC
All providers in Macon, GA · Psychiatry Physician in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 1, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.