Adel A Ghaffari
Individual provider Active NPI Physical Therapist · Austell, GA
NPI 1619986650 · NPPES record last updated Jan 25, 2008
Key facts
- NPI
- 1619986650
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 2574 (GA)
- Practice address
- 1810 Mulkey Rd Ste 101
Austell, GA 30106-1132 - Phone
- (678) 642-7039
- Fax
- (770) 475-5385
- NPI assigned
- Aug 7, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 4
Medicare Care Compare profile
- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 1979
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
1810 Mulkey Rd
Austell, GA 30106-1132
Phone (770) 948-6537
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in GA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20080624000147 | GA | Practitioner - Physical Therapist in Private Practice | 4587630611 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2574 | GA | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| McPars Physical Therapy and Rehab Associates PC | Physical Therapist | Current |
Accepting new patients |
| Jorge a. Bueno Chiropractic LLC | Past | Accepting new patients | |
| Christopher J. Lee MD, P.C. | Past | Accepting new patients | |
| A Family Practice and Wellness Center | Past |
Accepting new patients |
Locations
1810 Mulkey Rd
Ste 101
Austell, GA 30106
Phone (770) 948-6537
3500 Duluth Park Ln
Ste 210
Duluth, GA 30096
Phone (770) 475-3720
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 2574 | GA | Yes |
Addresses
Primary practice location
1810 Mulkey Rd Ste 101
Austell, GA 30106-1132
Mailing address
1810 Mulkey Rd Ste 101
Austell, GA 30106-1132
Phone (678) 642-7039
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| P00387224 | Other | GA | RAILROAD MEDICARE |
Other providers in Austell, GA
- Georgia Spine and Brain, PC
- Georgia Urology PA
- Georgia Veincare LLC
- Fatima German
- Quimia Symone Gerren
- Yacob Ghebremeskel
- Gi Specialists of Georgia
- Joy E. Gilbert
- Yasmeen Girardeau
- Rifquat Giwa
All providers in Austell, GA · Physical Therapist in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 25, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.