NPIMap

Individual provider Active NPI

Hisham Fozi Qutob, M.D.

  • Pulmonary Disease Physician
  • Cumming, GA
National Provider Identifier
1578723177
Registry record updated Apr 4, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
86852 Issued in GA
Practice address
1505 Northside Blvd Ste 3500
Cumming, GA 30041-8223
Phone
(770) 292-3120
Fax
(770) 292-3121
NPI assigned
Jun 17, 2008
Last updated
Apr 4, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 4, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine (Internal Medicine) Physician 207RC0200X 86852 GA
Pulmonary Disease Physician 207RP1001X 86852 GA Primary

Addresses

Primary practice location

1505 Northside Blvd Ste 3500
Cumming, GA 30041-8223

Mailing address

1505 Northside Blvd Ste 3500
Cumming, GA 30041-8223
Phone (770) 292-3120

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201125002485 GA Practitioner - Pulmonary DiseasePractitioner - Critical Care (Intensivists) 4880813625 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pulmonary DiseaseAlso: Critical Care (Intensivists)
Education
University of Utah School of Medicine, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1505 Northside Blvd
Suite 3500
Cumming, GA 30041-7623
Phone (770) 292-3120

743 Spring Nest
Gainesville, GA 30501-3715
Phone (770) 219-6000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
87.83 of 100Reported as group
Quality
80.36
Promoting interoperability
100
Improvement activities
40
Cost
79.08

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Northside Primary Care Professional Services, LLC CurrentSince Apr 1, 2026 Accepting new patients
Memorial Health Partners Foundation Inc Current Accepting new patients
Northeast Georgia Physicians Group Inc Critical Care Medicine CurrentSince Nov 18, 2020 Accepting new patients
Northside Primary Care Professional Services,LLC CurrentSince Apr 1, 2026 Accepting new patients
Northeast Georgia Medical Center, Inc. Past Accepting new patients

Locations

1400 River Pl
Braselton, GA 30517
Phone (770) 219-6000

1505 Northside Blvd
Ste 3500
Cumming, GA 30041
Phone (770) 292-3120

597 S Enota Dr NE
Gainesville, GA 30501
Phone (770) 219-8275

743 Spring St NE
Gainesville, GA 30501
Phone (770) 219-5915

3350 Paddocks Pkwy
Suwanee, GA 30024
Phone (678) 474-9633

Interoperability endpoints

  • Direct secure messaging: hishamqutob@tnmhpf.allscriptsdirect.net

Organizations & group practices 5

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.

Hospital & facility affiliations 4

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": "1213660800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775260800000",
    "number": "1578723177",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1505 NORTHSIDE BLVD STE 3500",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "300418223",
            "telephone_number": "770-292-3120",
            "fax_number": "770-292-3121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1505 NORTHSIDE BLVD STE 3500",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "300418223",
            "telephone_number": "770-292-3120",
            "fax_number": "770-292-3121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QUTOB",
        "first_name": "HISHAM",
        "middle_name": "FOZI",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-17",
        "last_updated": "2026-04-04",
        "certification_date": "2026-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "GA",
            "license": "86852",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "GA",
            "license": "86852",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cumming, GA

Sources for this page

Verify at the official NPI Registry.