Raju Midha, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

54164 Issued in GA

Practice address

1404 Montreal Rd
Tucker, GA 30084

Phone

(770) 492-8665

Fax

(770) 492-8663

NPI assigned

Oct 24, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

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

Family Practice

Education

Other, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Hospital & facility affiliations

• Emory Decatur Hospital Hospital, Decatur, GA, CCN 110076
• Northside Hospital Hospital, Atlanta, GA, CCN 110161
• Decatur Center for Nursing and Healing LLC Nursing home, Decatur, GA, CCN 115246

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/EBGCCD/Endpoint/EBGCCD
• Direct secure messaging: raju.midha@gadirect.net

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.

• Midha Medical Clinic

  • Family Medicine Physician
  • Tucker, GA
  • NPI 1649579046
  Medicare reassignment NPD Authorized official
• Gravante Chiropractic & Nutrition Inc.

  • Chiropractor
  • Snellville, GA
  • NPI 1841536000
  NPD
• Metro Medical Associates LLC

  • Family Medicine Physician
  • Alpharetta, GA
  • NPI 1982619789
  NPD
• Aylo Health, LLC

  • Family Medicine Physician
  • Atlanta, GA
  • NPI 1013018811
  NPD (past)
• Aylo Health, LLC

  • Family Medicine Physician
  • Ellenwood, GA
  • NPI 1447290218
  NPD (past)
• Aylo Health, LLC

  • Family Medicine Physician
  • Locust Grove, GA
  • NPI 1710929914
  NPD (past)
• Aylo Health, LLC

  • Sleep Medicine (Family Medicine) Physician
  • Stockbridge, GA
  • NPI 1922831445
  NPD (past)

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

• Decatur Center for Nursing and Healing LLC

  • Skilled Nursing Facility
  • Decatur, GA
  • NPI 1972215671

  Nursing home

  Care Compare affiliation
• Dekalb Medical Center, Inc.

  • General Acute Care Hospital
  • Decatur, GA
  • NPI 1093716979
  Care Compare affiliation
• Northside Hospital, Inc.

  • General Acute Care Hospital
  • Atlanta, GA
  • NPI 1457396079
  Care Compare affiliation

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

{
    "created_epoch": "1130112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604361600000",
    "number": "1497745251",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1404 MONTREAL RD",
            "city": "TUCKER",
            "state": "GA",
            "postal_code": "30084",
            "telephone_number": "770-492-8665",
            "fax_number": "770-492-8663"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1404 MONTREAL RD",
            "city": "TUCKER",
            "state": "GA",
            "postal_code": "30084",
            "telephone_number": "770-492-8665",
            "fax_number": "770-492-8663"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIDHA",
        "first_name": "RAJU",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-10-24",
        "last_updated": "2020-11-03",
        "certification_date": "2020-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "54164",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "054164",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003108944B",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michael Bailey Associates LLC
• Robert James Michelich, D.D.S.
• Bridgette Michelin, PA-C
• Midha Medical Clinic
• Inuka Midha, PHD MPH MCHES CDCES
• Laura L. Mika, LMSW
• Mike Berry'S Opticians Inc.
• Corinne D. Miller, OT
• Vernee Faye Ann Miller, RN
• William Michael Miller, MD

• Family Medicine Physician in Tucker, GA
• Providers in Tucker, GA by specialty
• Family Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2020; 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.