Individual provider Active NPI

Saurabh Desai, MD

  • Internal Medicine Physician
  • Douglasville, GA
National Provider Identifier
1578626602
Registry record updated Jan 5, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
027530 Issued in GA
Practice address
6025 Professional Pkwy
Suite 200
Douglasville, GA 30134-5609
Phone
(770) 949-0555
Fax
(770) 949-4424
NPI assigned
Dec 19, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 027530 GA Primary

Addresses

Primary practice location

6025 Professional Pkwy
Suite 200
Douglasville, GA 30134-5609

Mailing address

6025 Professional Pkwy
Suite 200
Douglasville, GA 30134-5609
Phone (770) 949-0555

Other identifiers 1

IdentifierTypeStateIssuer
00305302BMedicaidGA

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
I20100916001177 GA Practitioner - Internal Medicine 7214032689 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1979
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Qcpi-Villagemd PCGroup PAC ID 8123389277, 76 clinicians

Practice addresses (Care Compare)

1805 Parke Plaza Cir
Suite 101
Stone Mountain, GA 30087-3646
Phone (770) 879-0436

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
027530GAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Douglas Medical Group Current Accepting new patients
Homestead Hospice of Cartersville, LLC CurrentSince Aug 25, 2022 Accepting new patients
Douglas Hospital, Inc. Past Accepting new patients

Locations

100 Market Place Blvd
Ste 301
Cartersville, GA 30121
Phone (678) 290-4817

6025 Professional Pkwy
Ste 200
Douglasville, GA 30134
Phone (770) 949-0555

6025 Professional Pkwy
Douglasville, GA 30134
Phone (770) 949-0555

Interoperability endpoints

  • Direct secure messaging: saurabh.desai.1@21533.direct.athenahealth.com

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 and National Provider Directory roles.

Hospital & facility affiliations 7

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

NPI Registry JSON

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

{
    "created_epoch": "1166486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1451952000000",
    "number": "1578626602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6025 PROFESSIONAL PKWY",
            "address_2": "SUITE 200",
            "city": "DOUGLASVILLE",
            "state": "GA",
            "postal_code": "301345609",
            "telephone_number": "770-949-0555",
            "fax_number": "770-949-4424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6025 PROFESSIONAL PKWY",
            "address_2": "SUITE 200",
            "city": "DOUGLASVILLE",
            "state": "GA",
            "postal_code": "301345609",
            "telephone_number": "770-949-0555",
            "fax_number": "770-949-4424"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DESAI",
        "first_name": "SAURABH",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-19",
        "last_updated": "2016-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "027530",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00305302B",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Douglasville, GA

Sources for this page

Verify at the official NPI Registry.