Omer M Mirza, MD

Primary specialty

Interventional Cardiology PhysicianTaxonomy code 207RI0011X

License

83711 Issued in GA

Practice address

1700 Hospital South Dr Ste 409
Austell, GA 30106-8159

Phone

(770) 732-9100

NPI assigned

Apr 1, 2011

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

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

Specialty

Interventional CardiologyAlso: Cardiovascular Disease (Cardiology)

Education

University of Missouri, Kansas City, School of Medicine, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Wellstar Medical Group LLCGroup PAC ID 6709065402, 3,059 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Wellstar Cobb Medical Center Hospital, Austell, GA, CCN 110143
• Wellstar Kennestone Regional Medical Center Hospital, Marietta, GA, CCN 110035
• Wellstar Douglas Medical Center Hospital, Douglasville, GA, CCN 110184
• Wellstar Paulding Medical Center Hospital, Hiram, GA, CCN 110042

Merit-based Incentive Payment System (MIPS)

Final score

93.93 of 100Reported as apm

Quality

82.14

Promoting interoperability

100

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: omirza340434@directwellstar.org

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.

• Wellstar Medical Group, LLC

  • Family Medicine Physician
  • Kennesaw, GA
  • NPI 1558664003

  GA

  Medicare reassignment Care Compare group NPD
• Wellstar Medical Group, LLC

  • Multi-Specialty Clinic/Center
  • Marietta, GA
  • NPI 1275992240
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Cobb Hospital, Inc

  • General Acute Care Hospital
  • Austell, GA
  • NPI 1467420448

  Hospital

  Care Compare affiliation
• Douglas Hospital, Inc.

  • General Acute Care Hospital
  • Douglasville, GA
  • NPI 1649247974

  Hospital

  Care Compare affiliation
• Kennestone Hospital, Inc.

  • General Acute Care Hospital
  • Marietta, GA
  • NPI 1649248626

  Hospital

  Care Compare affiliation
• Paulding Medical Center, Inc.

  • General Acute Care Hospital
  • Hiram, GA
  • NPI 1457329435

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1301616000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576627200000",
    "number": "1497044259",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 HOSPITAL SOUTH DR STE 409",
            "city": "AUSTELL",
            "state": "GA",
            "postal_code": "301068159",
            "telephone_number": "770-732-9100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 HOSPITAL SOUTH DR STE 409",
            "city": "AUSTELL",
            "state": "GA",
            "postal_code": "301068159",
            "telephone_number": "770-732-9100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1740 W Taylor St",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606127232",
            "country_code": "US",
            "telephone_number": "866-600-2273",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MIRZA",
        "first_name": "OMER",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-04-01",
        "last_updated": "2019-12-18",
        "certification_date": "2019-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MO",
            "license": null,
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "GA",
            "license": "83711",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "omirza340434@directwellstar.org",
            "affiliation": "N",
            "address_1": "1700 Hospital South Dr Ste 409",
            "city": "Austell",
            "state": "GA",
            "country_code": "US",
            "postal_code": "301068159",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Chad Miller, MD
• Michael S. Miller, DPM
• Wesley Miller, DO
• Jerakhine N Mills, FNP
• Minddevelopers Counseling & Supervision PC
• Prashant Mishra, MD
• Taylor Mitchell, RDN, LDN
• Bashayer Mohammed, MD
• Elahe Mohazab
• Anikraza Momin, PA

• Interventional Cardiology Physician in Austell, GA
• Providers in Austell, GA by specialty
• Interventional Cardiology Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2019; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.