Active NPI
Niraj Khandelwal, MD, MHS
- Gastroenterology Physician
- Fayetteville, GA
National Provider Identifier
1619186228
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gastroenterology Physician
- License
- 67781
- Practice address
- 1265 Highway 54 W
Suite 402
Fayetteville, GA 30214-4548 - Phone
- (770) 719-3240
- Fax
- (770) 719-3241
- NPI assigned
- May 21, 2007
- Last updated
- Jul 9, 2012
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | NU | ||
| Gastroenterology Physician | 207RG0100X | 57.017193 | OH | |
| Gastroenterology Physician | 207RG0100X | 67781 | GA | Primary |
Addresses
Primary practice location
1265 Highway 54 W
Suite 402
Fayetteville, GA 30214-4548
Mailing address
95 Collier Rd NW
Suite 4075
Atlanta, GA 30309-1796
Phone (404) 355-3200
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| BP1-0022713 | Other | INSTITUTIONAL PERMIT |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Gastroenterology
- Education
- Johns Hopkins University School of Medicine, 2009
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
3280 Howell Mill Rd NW
Suite T100
Atlanta, GA 30327-4122
Phone 40460335431516
Hospital & facility affiliations
Merit-based Incentive Payment System (MIPS)
- Final score
- 91.62 of 100
- Quality
- 83.25
- Promoting interoperability
- 100
- Improvement activities
- 40
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Colonoscopy | 123 |
| Upper gastrointestinal (GI) endoscopy for acid reflux | 185 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 57.017193 | OH | MD | Gastroenterology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Digestive Healthcare of Ga, P.C. | Gastroenterology | Current | Accepting new patients |
| Progressive Anesthesia LLC | Past | Accepting new patients |
Locations
3280 Howell Mill Rd NW
Ste T100
Atlanta, GA 30327
Phone (404) 355-3200
95 Collier Rd NW
Ste 4075
Atlanta, GA 30309
Phone (404) 355-2200
1265 Highway 54 W
Ste 402
Fayetteville, GA 30214
Phone (678) 817-6550
Organizations & group practices 2
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.
-
- Gastroenterology Physician
- Atlanta, GA
- NPI 1558365247
-
- Anesthesiology Physician
- Fayetteville, GA
- NPI 1215225560
Hospital & facility affiliations 3
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Piedmont Fayette Hospital
- General Acute Care Hospital
- Fayetteville, GA
- NPI 1528027240
-
- General Acute Care Hospital
- Newnan, GA
- NPI 1134133002
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179705600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1341792000000",
"number": "1619186228",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "95 COLLIER RD NW",
"address_2": "SUITE 4075",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303091796",
"telephone_number": "404-355-3200",
"fax_number": "404-355-9316"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1265 HIGHWAY 54 W",
"address_2": "SUITE 402",
"city": "FAYETTEVILLE",
"state": "GA",
"postal_code": "302144548",
"telephone_number": "770-719-3240",
"fax_number": "770-719-3241"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KHANDELWAL",
"first_name": "NIRAJ",
"credential": "MD, MHS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-05-21",
"last_updated": "2012-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "NU",
"license": null,
"primary": false
},
{
"code": "207RG0100X",
"taxonomy_group": "",
"desc": "Internal Medicine, Gastroenterology",
"state": "OH",
"license": "57.017193",
"primary": false
},
{
"code": "207RG0100X",
"taxonomy_group": "",
"desc": "Internal Medicine, Gastroenterology",
"state": "GA",
"license": "67781",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "INSTITUTIONAL PERMIT",
"identifier": "BP1-0022713",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Fayetteville, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2012; 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.