Individual provider Active NPI

Hitendra Hansalia, M.D.

  • Obstetrics & Gynecology Physician
  • Austell, GA
National Provider Identifier
1659349454
Registry record updated Aug 20, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
46544 Issued in GA
Practice address
1810 Mulkey Rd
Suite 102
Austell, GA 30106-1151
Phone
(770) 944-8660
Fax
(770) 944-8661
NPI assigned
Mar 9, 2006
Last updated
Aug 20, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 46544 GA Primary

Addresses

Primary practice location

1810 Mulkey Rd
Suite 102
Austell, GA 30106-1151

Mailing address

1810 Mulkey Rd
Suite 102
Austell, GA 30106-1151
Phone (770) 944-8660

Other identifiers 1

IdentifierTypeStateIssuer
00811379AMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110128000714 GA Practitioner - Obstetrics/Gynecology 2567548449 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Other, 1984
Medicare assignment
May accept Medicare assignment
Group practices
Cobb Womens Health PAGroup PAC ID 5294811170, 2 clinicians

Practice addresses (Care Compare)

1810 Mulkey Rd
Austell, GA 30106-1132
Phone (770) 944-8660

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
46544GAMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cobb Women's Health, P.a. Obstetrics & Gynecology CurrentSince Feb 8, 1999 Accepting new patients

Locations

1810 Mulkey Rd
Ste 102
Austell, GA 30106
Phone (770) 944-8660

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.

Hospital & facility affiliations 1

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": "1141862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1282262400000",
    "number": "1659349454",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1810 MULKEY RD",
            "address_2": "SUITE 102",
            "city": "AUSTELL",
            "state": "GA",
            "postal_code": "301061151",
            "telephone_number": "770-944-8660",
            "fax_number": "770-944-8661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1810 MULKEY RD",
            "address_2": "SUITE 102",
            "city": "AUSTELL",
            "state": "GA",
            "postal_code": "301061151",
            "telephone_number": "770-944-8660",
            "fax_number": "770-944-8661"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANSALIA",
        "first_name": "HITENDRA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-09",
        "last_updated": "2010-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "GA",
            "license": "46544",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00811379A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Austell, GA

Sources for this page

Verify at the official NPI Registry.