Individual provider Active NPI

Muaz Alaaeldin Ibrahim, M.D

  • Diagnostic Radiology Physician
  • Augusta, GA
National Provider Identifier
1649702234
Registry record updated Nov 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
92925 Issued in GA
Practice address
1120 15TH St
Augusta, GA 30912-1606
Phone
(706) 721-0211
NPI assigned
Apr 1, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 28, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X GA
Diagnostic Radiology Physician 2085R0202X 92925 GA Primary

Addresses

Primary practice location

1120 15TH St
Augusta, GA 30912-1606

Mailing address

5605 Glenridge Dr Ste 325
Atlanta, GA 30342-1301
Phone (404) 252-4709

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, SC2 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
I20220809003542 GA Practitioner - Diagnostic Radiology 7810248663 Reassigns benefits to 4 organizations
I20260221000698 SC Practitioner - Diagnostic Radiology 7810248663 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northside Radiology Associates LLCGroup PAC ID 4486555398, 381 clinicians
Greensboro Radiology PAGroup PAC ID 8729074901, 236 clinicians

Practice addresses (Care Compare)

1000 Johnson Ferry Rd
Atlanta, GA 30342-1606
Phone (404) 662-2438

1000 Johnson Ferry Rd NE
Atlanta, GA 30342-1606
Phone (404) 662-2438

102 Grand Cres
Alpharetta, GA 30009-6817
Phone (336) 274-6682

3400 Old Milton Pkwy
Suite C110
Alpharetta, GA 30005-3769
Phone (404) 851-6577

6487 Creekview Cir
Johns Creek, GA 30097-5315
Phone (404) 851-6577

Hospital & facility affiliations

  • Northside Hospital Forsyth Hospital, Cumming, GA, CCN 110005
  • Northside Hospital Cherokee Hospital, Canton, GA, CCN 110008
  • Northside Hospital Hospital, Atlanta, GA, CCN 110161
  • Piedmont Columbus Regional Midtown Hospital, Columbus, GA, CCN 110064
  • Alamance Regional Medical Center Hospital, Burlington, NC, CCN 340070

Merit-based Incentive Payment System (MIPS)

Final score
96.75 of 100Reported as group
Quality
96.18
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Greensboro Radiology, PA Diagnostic Radiology CurrentSince Dec 28, 2025 Accepting new patients
Wellstar Medical Group, LLC CurrentSince Mar 1, 2024 Accepting new patients
Au Medical Associates Inc CurrentSince Aug 1, 2022 Accepting new patients
Au Medical Center, Inc Current Accepting new patients
Wellstar Medical Group, LLC Current Accepting new patients
Northside Radiology Associates LLC Diagnostic Radiology CurrentSince Mar 5, 2024 Accepting new patients
Au Medical Associates Inc CurrentSince Aug 1, 2022 Accepting new patients

Locations

1120 15th St
Augusta, GA 30912
Phone (706) 721-3873

1120 15th St
#6000
Augusta, GA 30912
Phone (706) 721-3813

400 Walmart Way
Ste Fb
Dahlonega, GA 30533
Phone (706) 867-7666

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

1602 Vernon Rd
Ste 200
Lagrange, GA 30240
Phone (478) 292-7962

106 Lukken Industrial Dr W
Lagrange, GA 30240
Phone (706) 880-7204

2200 Vernon St
Lagrange, GA 30240

303 Medical Dr
Ste 405
Lagrange, GA 30240
Phone (706) 812-2229

300 Medical Dr
Ste 707
Lagrange, GA 30240
Phone (706) 803-7920

1420 Vernon Rd
Lagrange, GA 30240
Phone (706) 880-7411

5605 Glenridge Dr
Ste 325
Sandy Springs, GA 30342
Phone (678) 553-7783

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

4700 Waters Ave
Savannah, GA 31404
Phone (912) 273-1100

Organizations & group practices 7

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.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1491004800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701129600000",
    "number": "1649702234",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5605 GLENRIDGE DR STE 325",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303421301",
            "telephone_number": "404-252-4709"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1120 15TH ST",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309121606",
            "telephone_number": "706-721-0211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IBRAHIM",
        "first_name": "MUAZ",
        "middle_name": "ALAAELDIN",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-04-01",
        "last_updated": "2023-11-28",
        "certification_date": "2023-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "GA",
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "GA",
            "license": "92925",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Augusta, GA

Sources for this page

Verify at the official NPI Registry.