Individual provider Active NPI

Desiree La Charite, MD

  • Emergency Medicine Physician
  • Atlanta, GA
National Provider Identifier
1649246570
Registry record updated Oct 13, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
062132 Issued in GA
Practice address
5665 New Northside Dr NW
Suite 320
Atlanta, GA 30328-5831
Phone
(770) 874-5400
Fax
(770) 874-5469
NPI assigned
Feb 28, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 13, 2009

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 43170 WI
Emergency Medicine Physician 207P00000X 062132 GA Primary

Addresses

Primary practice location

5665 New Northside Dr NW
Suite 320
Atlanta, GA 30328-5831

Mailing address

2950 Mount Wilkinson Pkwy SE
#604
Atlanta, GA 30339-3637
Phone (608) 829-5201

Other identifiers 3

IdentifierTypeStateIssuer
34114500MedicaidWI
619228407EMedicaidGA
6192287407CMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, FL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20090612000400 GA Practitioner - Emergency MedicinePractitioner - Critical Care (Intensivists) 8224188214 Reassigns benefits to 3 organizations
I20200915002941 FL Practitioner - Emergency Medicine 8224188214

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
93.93 of 100Reported as apm
Quality
82.14
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
062132GAMDEmergency Medicine Physician
43170WIMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Northside Emergency Associates, LLC Emergency Medicine CurrentSince Jul 1, 2014 Accepting new patients
The Bortolazzo Group, LLC Emergency Medicine CurrentSince Apr 1, 2009 Accepting new patients
Wellstar Medical Group, LLC CurrentSince Feb 1, 2021 Accepting new patients
Wellstar Medical Group, LLC Current Accepting new patients
Sterling Emergency Services of the Southeast, Inc Emergency Medicine Past Accepting new patients

Locations

3950 Austell Rd
Austell, GA 30106
Phone (770) 732-3752

1170 Cleveland Ave
East Point, GA 30344
Phone (404) 305-3500

5150 Stilesboro Rd NW
Ste 220
Kennesaw, GA 30152
Phone (770) 424-8222

1000 Johnson Ferry Rd
Sandy Springs, GA 30342
Phone (404) 851-8737

5665 New Northside Dr
Ste 320
Sandy Springs, GA 30328
Phone (770) 874-5468

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/14272/brand/70/csg/1/fhir/r4

Organizations & group practices 5

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": "1141084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1255392000000",
    "number": "1649246570",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2950 MOUNT WILKINSON PKWY SE",
            "address_2": "#604",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303393637",
            "telephone_number": "608-829-5201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5665 NEW NORTHSIDE DR NW",
            "address_2": "SUITE 320",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303285831",
            "telephone_number": "770-874-5400",
            "fax_number": "770-874-5469"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LA CHARITE",
        "first_name": "DESIREE",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-02-28",
        "last_updated": "2009-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "WI",
            "license": "43170",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "GA",
            "license": "062132",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "34114500",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "619228407E",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6192287407C",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.