Individual provider Active NPI

Deval Patel

  • Emergency Medicine Physician
  • Atlanta, GA
National Provider Identifier
1477768513
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
059317 Issued in GA
Practice address
5665 New Northside Dr NW
Atlanta, GA 30328-5831
Phone
(770) 874-5400
NPI assigned
May 11, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 059317 GA Primary

Addresses

Primary practice location

5665 New Northside Dr NW
Atlanta, GA 30328-5831

Mailing address

3950 Austell Rd
Austell, GA 30106-1121
Phone (770) 732-4000

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
I20070731000265 GA Practitioner - Emergency Medicine 1557462819 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
059317GAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Bortolazzo Group, LLC Emergency Medicine CurrentSince Jul 1, 2008 Accepting new patients
Wellstar Medical Group, LLC Current Accepting new patients
Cartersville Emergency Physicians, LLC Emergency Medicine Past Accepting new patients
Augusta Physicians Group, LLC Emergency Medicine PastSince Jan 26, 2020 Accepting new patients

Locations

1350 Walton Way
Augusta, GA 30901
Phone (706) 722-9011

3950 Austell Rd
Austell, GA 30106
Phone (770) 732-3752

600 W Memorial Dr
Dallas, GA 30132
Phone (770) 443-7072

8954 Hospital Dr
Douglasville, GA 30134
Phone (678) 838-2584

677 Church St NE
Marietta, GA 30060
Phone (770) 793-5435

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/14272/brand/70/csg/1/fhir/r4
  • Direct secure messaging: dpatel62122@directwellstar.org

Organizations & group practices 4

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1178841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1477768513",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3950 AUSTELL RD",
            "city": "AUSTELL",
            "state": "GA",
            "postal_code": "301061121",
            "telephone_number": "770-732-4000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5665 NEW NORTHSIDE DR NW",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303285831",
            "telephone_number": "770-874-5400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "DEVAL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "GA",
            "license": "059317",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.