Individual provider Active NPI

Lazaros K Kochilas, M.D.

  • Pediatric Cardiology Physician
  • Atlanta, GA
National Provider Identifier
1548232036
Registry record updated Mar 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Cardiology PhysicianTaxonomy code 2080P0202X
License
073331 Issued in GA
Practice address
5461 Meridian Mark Rd Ste 530
Atlanta, GA 30342-3283
Phone
(404) 256-2593
Fax
(770) 488-9408
NPI assigned
Feb 7, 2006
Last updated
Mar 24, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Cardiology Physician 2080P0202X 073331 GA Primary
Pediatric Cardiology Physician 2080P0202X MD11036 RI
Pediatric Cardiology Physician 2080P0202X 216383 MA

Addresses

Primary practice location

5461 Meridian Mark Rd Ste 530
Atlanta, GA 30342-3283

Mailing address

2835 Brandywine Rd
Suite 300
Atlanta, GA 30341-5510
Phone (404) 256-2593

Other identifiers 1

IdentifierTypeStateIssuer
7010302MedicaidRI

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address sibley@choa.gadirect.com Health Information Exchange (HIE) Children's Healthcare of Atlanta

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
I20170320000596 GA Practitioner - Pediatric Medicine 4880671049 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
073331GAMDPediatric Cardiology Physician
216383MAMDPediatric Cardiology Physician
MD11036RIMDPediatric Cardiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Childrens Healthcare of Atlanta Cardiology Inc Pediatric Cardiology CurrentSince Feb 1, 2017 Accepting new patients
Jefferson University Physicians Past Accepting new patients
Egleston Children's Hospital at Emory University, Inc. Past Accepting new patients
Arthur M. Blank Hospital, Inc. Past Accepting new patients

Locations

2835 Brandywine Rd
Ste 300
Atlanta, GA 30341
Phone (770) 488-9202

60 Executive Park South NE
Atlanta, GA 30329

5461 Meridian Mark Rd
Ste 530
Sandy Springs, GA 30342

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": "1139270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679616000000",
    "number": "1548232036",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2835 BRANDYWINE RD",
            "address_2": "SUITE 300",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303415510",
            "telephone_number": "404-256-2593",
            "fax_number": "770-488-9408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5461 MERIDIAN MARK RD STE 530",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303423283",
            "telephone_number": "404-256-2593",
            "fax_number": "770-488-9408"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOCHILAS",
        "first_name": "LAZAROS",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-07",
        "last_updated": "2023-03-24",
        "certification_date": "2023-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0202X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": "GA",
            "license": "073331",
            "primary": true
        },
        {
            "code": "2080P0202X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": "RI",
            "license": "MD11036",
            "primary": false
        },
        {
            "code": "2080P0202X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": "MA",
            "license": "216383",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7010302",
            "state": "RI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sibley@choa.gadirect.com",
            "affiliation": "Y",
            "endpointDescription": "Sibley",
            "affiliationName": "Children's Healthcare of Atlanta",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "PHI",
            "address_1": "5461 Meridian Mark Rd Ste 530",
            "city": "Atlanta",
            "state": "GA",
            "country_code": "US",
            "postal_code": "303423283",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.