Ali Mortazavi, D.O.

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

License

054865 Issued in GA

Practice address

2041 Mesa Valley Way
Suite 100
Austell, GA 30106-8157

Phone

(770) 944-1100

Fax

(770) 944-6469

NPI assigned

Oct 3, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 4

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

Specialty

Orthopedic SurgeryAlso: General Surgery

Education

R Franklin University of Med & Sci/Chicago Medical School, 1998

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Resurgens, LLCGroup PAC ID 1153224142, 184 clinicians

Physiotherapy Associates IncGroup PAC ID 3577470442, shared by 50 NPIs, 1,432 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• 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
• Wellstar Kennestone Regional Medical Center Hospital, Marietta, GA, CCN 110035
• Wellstar Windy Hill Hospital Long-term care hospital, Marietta, GA, CCN 112007

Merit-based Incentive Payment System (MIPS)

Final score

93.93 of 100Reported as apm

Quality

82.14

Promoting interoperability

100

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy, Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ali.mortazavi.1@15749.direct.athenahealth.com

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.

• Resurgens, LLC

  • Orthopaedic Surgery Physician
  • Atlanta, GA
  • NPI 1386697928
  Medicare reassignment Care Compare group NPD
• Resurgens, LLC

  • Orthopaedic Surgery Physician
  • Braselton, GA
  • NPI 1033919790
  NPD
• Resurgens, LLC

  • Orthopaedic Surgery Physician
  • Smyrna, GA
  • NPI 1821511676
  NPD

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

• Cobb Hospital, Inc

  • General Acute Care Hospital
  • Austell, GA
  • NPI 1467420448
  Care Compare affiliation
• Douglas Hospital, Inc.

  • General Acute Care Hospital
  • Douglasville, GA
  • NPI 1649247974
  Care Compare affiliation
• Kennestone Hospital, Inc.

  • General Acute Care Hospital
  • Marietta, GA
  • NPI 1649248626
  Care Compare affiliation
• Kennestone Hospital, Inc.

  • Long Term Care Hospital
  • Marietta, GA
  • NPI 1700853041

  Long-term care hospital

  Care Compare affiliation
• Paulding Medical Center, Inc.

  • General Acute Care Hospital
  • Hiram, GA
  • NPI 1457329435
  Care Compare affiliation

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

{
    "created_epoch": "1128297600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1477267200000",
    "number": "1609863802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2041 MESA VALLEY WAY",
            "address_2": "SUITE 100",
            "city": "AUSTELL",
            "state": "GA",
            "postal_code": "301068157",
            "telephone_number": "770-944-1100",
            "fax_number": "770-944-6469"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2041 MESA VALLEY WAY",
            "address_2": "SUITE 100",
            "city": "AUSTELL",
            "state": "GA",
            "postal_code": "301068157",
            "telephone_number": "770-944-1100",
            "fax_number": "770-944-6469"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORTAZAVI",
        "first_name": "ALI",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-03",
        "last_updated": "2016-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "GA",
            "license": "054865",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "234083867B",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "234083867E",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "234083867C",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "234083867A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nofisia Morisseau, ARNP
• Jonathan Morris
• Jymirah Morris, MD
• Nigel Sheldon Morris
• Saint-Aaron Morris I, MD, FAANS
• Barbara Jean Mroz, M.D.
• Christina Beth Mueller, FNP
• Mulkey Anesthesiology Associates LLC
• Multispecialty Services, LLC
• Amanda Murach, MPT

• Orthopaedic Surgery Physician in Austell, GA
• Providers in Austell, GA by specialty
• Orthopaedic Surgery Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.