Active NPI
Mustafa Farooq
- Internal Medicine Physician
- Augusta, GA
National Provider Identifier
1659197150
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 17830
- Practice address
- 1120 15TH St # Bi5070
Augusta, GA 30912-3247 - Phone
- (706) 721-2423
- NPI assigned
- Nov 29, 2024
- Last updated
- Jun 11, 2025
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 17830 | GA | Primary |
Addresses
Primary practice location
1120 15TH St # Bi5070
Augusta, GA 30912-3247
Mailing address
1480 Wrightsboro Rd Apt 1223
Augusta, GA 30901-3206
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250821000434 | GA | Order and Referring Only - Internal Medicine | 4587164918 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| August University - Medical College of Georgia | Internal Medicine | Current | Accepting new patients |
Locations
1120 15th St
#5070
Augusta, GA 30912
Phone (706) 721-2423
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Internal Medicine Physician
- Augusta, GA
- NPI 1730865619
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1732838400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1749600000000",
"number": "1659197150",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1480 WRIGHTSBORO RD APT 1223",
"city": "AUGUSTA",
"state": "GA",
"postal_code": "309013206"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1120 15TH ST # BI5070",
"city": "AUGUSTA",
"state": "GA",
"postal_code": "309123247",
"telephone_number": "706-721-2423"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FAROOQ",
"first_name": "MUSTAFA",
"name_prefix": "Mr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2024-11-29",
"last_updated": "2025-06-11",
"certification_date": "2025-06-11",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "GA",
"license": "17830",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Augusta, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2025; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.