Individual provider Active NPI

Anil J Desai, MD

  • Hematology & Oncology Physician
  • Covington, GA
National Provider Identifier
1578670071
Registry record updated Feb 25, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
035033 Issued in GA
Practice address
4139 Baker St NE
Covington, GA 30014-1405
Phone
(770) 786-9499
Fax
(770) 786-9757
NPI assigned
Aug 23, 2006
Last updated
Feb 25, 2016By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 25, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 035033 GA
Hematology & Oncology Physician 207RH0003X 035033 GA Primary

Addresses

Primary practice location

4139 Baker St NE
Covington, GA 30014-1405

Mailing address

3641 Highway 20 SE
Suite a
Conyers, GA 30013-3064
Phone (770) 918-1234

Other identifiers 1

IdentifierTypeStateIssuer
00588266CMedicaidGA

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
I20110425000427 GA Practitioner - Internal MedicinePractitioner - Hematology/Oncology 6002091766 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Hematology/Oncology
Education
Other, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4139 Baker St
Suite 900
Covington, GA 30014-1409
Phone (770) 786-9499

4139 Baker St NE
Covington, GA 30014-1409

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
035033GAMDHematology & Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Rockdale Newton Hematology Oncology Hematology & Oncology CurrentSince Apr 1, 1995 Accepting new patients
East Metro Internal Medicine Internal Medicine Current Accepting new patients
CMC Radiological Services PC Past Accepting new patients
CMC Radiological Services PC Past Accepting new patients

Locations

3641 Highway 20 SE
#A
Conyers, GA 30013
Phone (770) 918-1234

4139 Baker St NE
Covington, GA 30014
Phone (770) 786-9499

4139 Baker St NE
Ste 900
Covington, GA 30014
Phone (770) 786-9499

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/JDJBDA
  • FHIR API: https://fhir4.healow.com/fhir/r4/JHJBDA
  • FHIR API: https://fhir4.healow.com/fhir/r4/JHJBDA/Endpoint/JHJBDA

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": "1156291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1456358400000",
    "number": "1578670071",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3641 HIGHWAY 20 SE",
            "address_2": "SUITE A",
            "city": "CONYERS",
            "state": "GA",
            "postal_code": "300133064",
            "telephone_number": "770-918-1234",
            "fax_number": "770-918-1235"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4139 BAKER ST NE",
            "city": "COVINGTON",
            "state": "GA",
            "postal_code": "300141405",
            "telephone_number": "770-786-9499",
            "fax_number": "770-786-9757"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DESAI",
        "first_name": "ANIL",
        "middle_name": "J",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-23",
        "last_updated": "2016-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "035033",
            "primary": false
        },
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "GA",
            "license": "035033",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00588266C",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Covington, GA

Sources for this page

Verify at the official NPI Registry.