Individual provider Active NPI

Nirav Raman Patel, M.D.

  • Pediatric Gastroenterology Physician
  • Atlanta, GA
National Provider Identifier
1639339336
Registry record updated Jun 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Gastroenterology PhysicianTaxonomy code 2080P0206X
License
066615 Issued in GA
Practice address
5445 Meridian Marks Rd Ste 490
Atlanta, GA 30342-4794
Phone
(404) 843-6320
Fax
(404) 843-6321
NPI assigned
Jun 16, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Gastroenterology Physician 2080P0206X 2378151 NY
Pediatric Gastroenterology Physician 2080P0206X 31339 SC
Pediatric Gastroenterology Physician 2080P0206X 066615 GA Primary

Addresses

Primary practice location

5445 Meridian Marks Rd Ste 490
Atlanta, GA 30342-4794

Mailing address

933 Johnson Fy Rd NE Ste D440
Atlanta, GA 30342
Phone (404) 257-0799

Other practice location 1

3795 Mansell Rd
Alpharetta, GA 30022-8247
Phone (404) 257-0799

Other practice location 2

993 Johnson Fy Rd NE Ste D440
Atlanta, GA 30342-4780
Phone (404) 257-0799

Other practice location 3

833 Campbell Hill St NW Ste 340
Marietta, GA 30060-1137
Phone (404) 257-0799

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
I20140113001004 GA Practitioner - GastroenterologyPractitioner - Pediatric Medicine 2668600958 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2378151NYMDPediatric Gastroenterology Physician
31339SCMDPediatric Gastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Aga, LLC CurrentSince Jan 1, 2014 Accepting new patients
Scottish Rite Childrens Medical Ctr Past Accepting new patients

Locations

550 Peachtree St NE
Ste 1600
Atlanta, GA 30308
Phone (404) 881-1094

488 Kennesaw Ave NW
Ste 200
Marietta, GA 30060
Phone (770) 427-3075

2520 Windy Hill Rd SE
Ste 102
Marietta, GA 30067
Phone (770) 612-8165

2401 Newnan Crossing Blvd E
Ste 110
Newnan, GA 30265
Phone (678) 631-4610

5445 Meridian Mark Rd
Ste 490
Sandy Springs, GA 30342
Phone (404) 252-9307

Interoperability endpoints

  • Direct secure messaging: npatel66670@choa.gadirect.net

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1213574400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655683200000",
    "number": "1639339336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "933 JOHNSON FY RD NE STE D440",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "30342",
            "telephone_number": "404-257-0799",
            "fax_number": "404-256-5475"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5445 MERIDIAN MARKS RD STE 490",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303424794",
            "telephone_number": "404-843-6320",
            "fax_number": "404-843-6321"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3795 Mansell Rd",
            "address_purpose": "LOCATION",
            "city": "Alpharetta",
            "state": "GA",
            "postal_code": "300228247",
            "country_code": "US",
            "telephone_number": "404-257-0799",
            "fax_number": "404-256-5475",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "993 Johnson Fy Rd NE Ste D440",
            "address_purpose": "LOCATION",
            "city": "Atlanta",
            "state": "GA",
            "postal_code": "303424780",
            "country_code": "US",
            "telephone_number": "404-257-0799",
            "fax_number": "404-256-5475",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "833 Campbell Hill St NW Ste 340",
            "address_purpose": "LOCATION",
            "city": "Marietta",
            "state": "GA",
            "postal_code": "300601137",
            "country_code": "US",
            "telephone_number": "404-257-0799",
            "fax_number": "404-256-5475",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PATEL",
        "first_name": "NIRAV",
        "middle_name": "RAMAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-16",
        "last_updated": "2022-06-20",
        "certification_date": "2022-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0206X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Gastroenterology",
            "state": "NY",
            "license": "2378151",
            "primary": false
        },
        {
            "code": "2080P0206X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Gastroenterology",
            "state": "SC",
            "license": "31339",
            "primary": false
        },
        {
            "code": "2080P0206X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Gastroenterology",
            "state": "GA",
            "license": "066615",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.