Hasan Khosravi, MD

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

101902 Issued in GA

Practice address

1519 Johnson Ferry Rd Ste 175
Marietta, GA 30062-6411

Phone

(770) 814-8222

Fax

(678) 205-5111

NPI assigned

Jun 21, 2017

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Specialty

Dermatology

Education

Harvard Medical School, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

North Atlanta DermatologyGroup PAC ID 2163310533, 17 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• Healthfirst Medicare Network H1722
• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H3359
• Healthfirst Medicare Network H9678

Interoperability endpoints

• Direct secure messaging: hkhosravi@aadermaffiliates.emadirect.md

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.

• North Atlanta Dermatology

  • Dermatology Physician
  • Duluth, GA
  • NPI 1427040799
  Medicare reassignment Care Compare group NPD
• Axis Dermatology LLC

  • Dermatology Physician
  • Peachtree Corners, GA
  • NPI 1194658427
  NPD Authorized official
• Derm Specs of PA PLLC

  • Dermatology Physician
  • Philadelphia, PA
  • NPI 1528823507
  NPD

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

{
    "created_epoch": "1498003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780876800000",
    "number": "1649790627",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 23329",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100873329"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1519 JOHNSON FERRY RD STE 175",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300626411",
            "telephone_number": "770-814-8222",
            "fax_number": "678-205-5111"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1230 Bald Ridge Marina Rd Ste 300",
            "address_purpose": "LOCATION",
            "city": "Cumming",
            "state": "GA",
            "postal_code": "300417859",
            "country_code": "US",
            "telephone_number": "770-814-8222",
            "fax_number": "678-205-5111",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3331 Hamilton Mill Rd Ste 1106",
            "address_purpose": "LOCATION",
            "city": "Buford",
            "state": "GA",
            "postal_code": "305197226",
            "country_code": "US",
            "telephone_number": "770-814-8222",
            "fax_number": "678-205-5111",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3850 Pleasant Hill Rd",
            "address_purpose": "LOCATION",
            "city": "Duluth",
            "state": "GA",
            "postal_code": "300964807",
            "country_code": "US",
            "telephone_number": "770-814-8222",
            "fax_number": "678-205-5111",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3370 Paddocks Pkwy",
            "address_purpose": "LOCATION",
            "city": "Suwanee",
            "state": "GA",
            "postal_code": "300249119",
            "country_code": "US",
            "telephone_number": "770-814-8222",
            "fax_number": "678-205-5111",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "808 S Wood St Ste 380",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606127300",
            "country_code": "US",
            "telephone_number": "312-413-7448",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KHOSRAVI",
        "first_name": "HASAN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-06-21",
        "last_updated": "2026-06-08",
        "certification_date": "2026-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "GA",
            "license": "101902",
            "primary": true
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "IL",
            "license": "036.155306",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sheema Khan, M.D.
• Zain Khan, MD
• Ayesha Patel Khanduri, DO
• Rohit Mohan Khanna, M.D.
• Elaine Grace Khatod, M.D.
• Jon Khoury, PA
• Kidmunication, LLC
• Rachel Anne Kieran, PSY.D.
• Linda M Kiesler, CNP
• Christina Marie Kight, LCSW

• Dermatology Physician in Marietta, GA
• Providers in Marietta, GA by specialty
• Dermatology Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.