Individual provider Active NPI

Redah Z Mahmood, MD

  • Cardiovascular Disease Physician
  • Woodstock, GA
National Provider Identifier
1609030394
Registry record updated Oct 7, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
81668 Issued in GA
Practice address
120 Stonebridge Pkwy Ste 110
Woodstock, GA 30189-3768
Phone
(678) 324-4444
Fax
(678) 324-4405
NPI assigned
Jul 11, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2019

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 4301093085 MI
Internal Medicine Physician 207R00000X 4301093085 MI
Cardiovascular Disease Physician 207RC0000X 81668 GA Primary

Addresses

Primary practice location

120 Stonebridge Pkwy Ste 110
Woodstock, GA 30189-3768

Mailing address

55 Whitcher St NE Ste 350
Marietta, GA 30060-1129
Phone (470) 956-9639

Other identifiers 2

IdentifierTypeStateIssuer
1609030394MedicaidMI
12330056OtherCAQH

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address rmahmood287848@directwellstar.org

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
I20181217000772 GA Practitioner - Cardiovascular Disease (Cardiology) 7618144783 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
Wayne State University School of Medicine, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wellstar Medical Group LLCGroup PAC ID 6709065402, 3,059 clinicians

Practice addresses (Care Compare)

55 Whitcher Nest
Suite 220
Marietta, GA 30060-1168
Phone (770) 429-0083

Hospital & facility affiliations

  • Wellstar Kennestone Regional Medical Center Hospital, Marietta, GA, CCN 110035
  • Wellstar Cobb Medical Center Hospital, Austell, GA, CCN 110143
  • Wellstar Paulding Medical Center Hospital, Hiram, GA, CCN 110042
  • Wellstar Douglas Medical Center Hospital, Douglasville, GA, CCN 110184

Merit-based Incentive Payment System (MIPS)

Final score
93.93 of 100Reported as apm
Quality
82.14
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
81668GAMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wellstar Medical Group, LLC Current Accepting new patients
Wellstar Medical Group, LLC CurrentSince Oct 2, 2018 Accepting new patients
Wellstar Cardiovascular Medicine, LLC Cardiovascular Disease Past Accepting new patients

Locations

1120 Wellstar Way
Ste 303
Holly Springs, GA 30114
Phone (770) 704-1955

5150 Stilesboro Rd NW
Ste 220
Kennesaw, GA 30152
Phone (770) 424-8222

55 Whitcher St NE
Ste 220
Marietta, GA 30060
Phone (770) 429-0083

55 Whitcher St NE
Ste 350
Marietta, GA 30060

120 Stonebridge Pkwy
Ste 110
Woodstock, GA 30189
Phone (678) 324-4400

Interoperability endpoints

  • Direct secure messaging: rmahmood287848@directwellstar.org

Organizations & group practices 3

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 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": "1215734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1570406400000",
    "number": "1609030394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 WHITCHER ST NE STE 350",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300601129",
            "telephone_number": "470-956-9639",
            "fax_number": "678-819-0357"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 STONEBRIDGE PKWY STE 110",
            "city": "WOODSTOCK",
            "state": "GA",
            "postal_code": "301893768",
            "telephone_number": "678-324-4444",
            "fax_number": "678-324-4405"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAHMOOD",
        "first_name": "REDAH",
        "middle_name": "Z",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-11",
        "last_updated": "2019-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MI",
            "license": "4301093085",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301093085",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "GA",
            "license": "81668",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1609030394",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "12330056",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rmahmood287848@directwellstar.org",
            "affiliation": "N",
            "address_1": "120 Stonebridge Pkwy Ste 110",
            "city": "Woodstock",
            "state": "GA",
            "country_code": "US",
            "postal_code": "301893768",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Woodstock, GA

Sources for this page

Verify at the official NPI Registry.