Individual provider Active NPI

Asha Shah Prasad, MD

  • Internal Medicine Physician
  • Duluth, GA
National Provider Identifier
1629236286
Registry record updated Jan 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
65494 Issued in GA
Practice address
3490 Pleasant Hill Rd
Duluth, GA 30096
Phone
(770) 814-2870
Fax
(770) 814-2872
NPI assigned
May 29, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 65494 GA Primary

Addresses

Primary practice location

3490 Pleasant Hill Rd
Duluth, GA 30096

Mailing address

10600 Medlock Bridge Rd
Duluth, GA 30097-8404

Other practice location 1

455 Beaver Ruin Rd NW
Lilburn, GA 30047-3413
Phone (770) 923-7778

Other practice location 2

4870 Lawrenceville Hwy
Tucker, GA 30084-2952
Phone (770) 496-1429

Other identifiers 1

IdentifierTypeStateIssuer
003113236MedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20240112001181 FL Practitioner - Internal Medicine 1456523190 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Holy Cross Hospital Inc Internal Medicine CurrentSince Jan 2, 2024 Accepting new patients
Holy Cross Hospital, Inc CurrentSince Jan 2, 2024 Accepting new patients
Gwinnett Clinic LTD Past Accepting new patients

Locations

1309 S Federal Hwy
#G
Ft Lauderdale, FL 33316
Phone (954) 463-4383

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.

NPI Registry JSON

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

{
    "created_epoch": "1212019200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673654400000",
    "number": "1629236286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10600 MEDLOCK BRIDGE RD",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "300978404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3490 PLEASANT HILL RD",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "30096",
            "telephone_number": "770-814-2870",
            "fax_number": "770-814-2872"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "455 Beaver Ruin Rd NW",
            "address_purpose": "LOCATION",
            "city": "Lilburn",
            "state": "GA",
            "postal_code": "300473413",
            "country_code": "US",
            "telephone_number": "770-923-7778",
            "fax_number": "770-806-1383",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4870 Lawrenceville Hwy",
            "address_purpose": "LOCATION",
            "city": "Tucker",
            "state": "GA",
            "postal_code": "300842952",
            "country_code": "US",
            "telephone_number": "770-496-1429",
            "fax_number": "770-270-5854",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PRASAD",
        "first_name": "ASHA",
        "middle_name": "SHAH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-05-29",
        "last_updated": "2023-01-14",
        "certification_date": "2023-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "65494",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003113236",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Duluth, GA

Sources for this page

Verify at the official NPI Registry.