Individual provider Active NPI

Malcolm D Joel, MD

  • Anatomic Pathology & Clinical Pathology Physician
  • East Point, GA
National Provider Identifier
1508829375
Registry record updated Oct 1, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
018033 Issued in GA
Practice address
1170 Cleveland Ave
Pathology Dept
East Point, GA 30344-3615
Phone
(404) 305-4285
Fax
(404) 305-3415
NPI assigned
Apr 11, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 018033 GA Primary

Addresses

Primary practice location

1170 Cleveland Ave
Pathology Dept
East Point, GA 30344-3615

Mailing address

PO Box 491240
Lawrenceville, GA 30049-0059
Phone (404) 305-4285

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
I20101104001057 GA Practitioner - Pathology 8022059070

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
18033GAMDInternal Medicine Physician
018033GAMDAnatomic Pathology & Clinical Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southern Gastroenterology Specialists, P.C CurrentSince Aug 1, 2010 Accepting new patients
Robert S. Smith MD, Inc PastSince Feb 7, 2013 Accepting new patients

Locations

4865 Bill Gardner Pkwy
Locust Grove, GA 30248
Phone (770) 692-0100

6555 Professional Pl
Ste C
Riverdale, GA 30274
Phone (770) 692-0100

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/GDFJAD

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1144713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1191196800000",
    "number": "1508829375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 491240",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300490059",
            "telephone_number": "404-305-4285",
            "fax_number": "404-305-3415"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1170 CLEVELAND AVE",
            "address_2": "PATHOLOGY DEPT",
            "city": "EAST POINT",
            "state": "GA",
            "postal_code": "303443615",
            "telephone_number": "404-305-4285",
            "fax_number": "404-305-3415"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOEL",
        "first_name": "MALCOLM",
        "middle_name": "D",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-11",
        "last_updated": "2007-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "GA",
            "license": "018033",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Point, GA

Sources for this page

Verify at the official NPI Registry.