Active NPI
Shoheb S Ali, M.D.
- Hospitalist Physician
- Lawrenceville, GA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Hospitalist Physician
- License
- 86041
- Practice address
- 1000 Medical Center Blvd
Lawrenceville, GA 30046-7694 - Phone
- (678) 312-3294
- Fax
- (678) 312-3282
- NPI assigned
- May 2, 2016
- Last updated
- Mar 5, 2023
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | MD17430 | RI | |
| Internal Medicine Physician | 207R00000X | 86041 | GA | |
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Hospitalist Physician | 208M00000X | 86041 | GA | Primary |
Addresses
Primary practice location
1000 Medical Center Blvd
Lawrenceville, GA 30046-7694
Mailing address
1000 Medical Center Blvd
Lawrenceville, GA 30046-7694
Phone (678) 312-3294
Other practice location 1
593 Eddy St
Providence, RI 02903-4923
Phone (401) 444-3985
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in RI
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lifespan Physician Group, Inc. | Current | Accepting new patients | |
| Lifespan Physician Group, Inc. | Current | Accepting new patients | |
| Gwinnett Medical Group, Inc | Internal Medicine | Past | Accepting new patients |
Locations
185A High Service Ave
North Providence, RI 02904
Phone (401) 354-6050
117 Ellenfield St
Ste 101
Providence, RI 02905
Phone (401) 444-4318
593 Eddy St
Providence, RI 02903
Interoperability endpoints
- shoheb.ali@450151672053764.direct.elationemr.com
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Brown Health Medical Group
- General Practice Physician
- Providence, RI
- NPI 1407116643
-
dba Brown Health Medical Group
- Emergency Medicine Physician
- Providence, RI
- NPI 1568325678
-
- General Practice Physician
- Lawrenceville, GA
- NPI 1780747469
Internal Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1462147200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1677974400000",
"number": "1477908192",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1000 MEDICAL CENTER BLVD",
"city": "LAWRENCEVILLE",
"state": "GA",
"postal_code": "300467694",
"telephone_number": "678-312-3294",
"fax_number": "678-312-3282"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1000 MEDICAL CENTER BLVD",
"city": "LAWRENCEVILLE",
"state": "GA",
"postal_code": "300467694",
"telephone_number": "678-312-3294",
"fax_number": "678-312-3282"
}
],
"practiceLocations": [
{
"address_1": "593 Eddy St",
"address_purpose": "LOCATION",
"city": "Providence",
"state": "RI",
"postal_code": "029034923",
"country_code": "US",
"telephone_number": "401-444-3985",
"fax_number": "401-444-3986",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "ALI",
"first_name": "SHOHEB",
"middle_name": "S",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-05-02",
"last_updated": "2023-03-05",
"certification_date": "2023-03-05",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "RI",
"license": "MD17430",
"primary": false
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "GA",
"license": "86041",
"primary": false
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "208M00000X",
"taxonomy_group": "",
"desc": "Hospitalist",
"state": "GA",
"license": "86041",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Lawrenceville, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.