Individual provider Active NPI

Manish Girish Shah, M.D.

  • Diagnostic Radiology Physician
  • Athens, GA
National Provider Identifier
1669675658
Registry record updated Dec 27, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
069708 Issued in GA
Practice address
1231 Founders Lake Dr
Athens, GA 30606-7645
Phone
(706) 495-9897
NPI assigned
Jun 7, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 27, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 099200 OH
Diagnostic Radiology Physician 2085R0202X 069708 GA Primary

Addresses

Primary practice location

1231 Founders Lake Dr
Athens, GA 30606-7645

Mailing address

1231 Founders Lake Dr
Athens, GA 30606-7645
Phone (706) 495-9897

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130730000729 GA Practitioner - Diagnostic Radiology 4082861687 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Medical College of Georgia School of Medicine, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Radiology Associates of North GeorgiaGroup PAC ID 2769715044, 36 clinicians
Athens Radiology Associates PCGroup PAC ID 2860486107, 34 clinicians

Practice addresses (Care Compare)

1199 Prince Ave
Athens, GA 30606-2797
Phone (706) 475-7000

1230 Baxter St
Athens, GA 30606-3712
Phone (706) 548-7581

245 Floyd Dr
Athens, GA 30607-1469
Phone (762) 356-4780

367 Clear Creek Pkwy
Lavonia, GA 30553-4173
Phone (706) 356-7800

Hospital & facility affiliations

  • Piedmont Athens Regional Medical Center Hospital, Athens, GA, CCN 110074
  • Piedmont Walton Hospital Hospital, Monroe, GA, CCN 110046
  • St Mary'S Hospital Hospital, Athens, GA, CCN 110006
  • Ty Cobb Regional Medical Center, LLC Hospital, Lavonia, GA, CCN 110027
  • St Marys Good Samaritan Hospital Hospital, Greensboro, GA, CCN 111329

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
069708GAMDDiagnostic Radiology Physician
099200OHMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Radiology Associates of North Georgia Diagnostic Radiology CurrentSince Nov 18, 2018 Accepting new patients
Synergy Radiology, LLC CurrentSince May 1, 2022 Accepting new patients
Synergy Radiology, LLC Diagnostic Radiology CurrentSince May 1, 2022 Accepting new patients
American Health Imaging of Georgia, LLC CurrentSince Dec 31, 2021 Accepting new patients
Athens Radiology Associates PC Diagnostic Radiology CurrentSince Jul 1, 2013 Accepting new patients
American Health Imaging of Georgia LLC CurrentSince May 1, 2022 Accepting new patients
M & B Imaging, PC Diagnostic Radiology CurrentSince Jan 22, 2022 Accepting new patients

Locations

1230 Baxter St
Athens, GA 30606
Phone (706) 364-3100

1199 Prince Ave
Athens, GA 30606
Phone (706) 354-3520

1501 Milstead Rd NE
Ste 140
Conyers, GA 30012

9459 Highway 5
Ste R
Douglasville, GA 30135

6025 Professional Pkwy
Ste 104
Douglasville, GA 30134
Phone (770) 444-9981

367 Clear Creek Pkwy
Lavonia, GA 30553
Phone (706) 356-7800

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": "1181174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1388102400000",
    "number": "1669675658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1231 FOUNDERS LAKE DR",
            "city": "ATHENS",
            "state": "GA",
            "postal_code": "306067645",
            "telephone_number": "706-495-9897"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1231 FOUNDERS LAKE DR",
            "city": "ATHENS",
            "state": "GA",
            "postal_code": "306067645",
            "telephone_number": "706-495-9897"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAH",
        "first_name": "MANISH",
        "middle_name": "GIRISH",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-07",
        "last_updated": "2013-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "OH",
            "license": "099200",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "GA",
            "license": "069708",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Athens, GA

Sources for this page

Verify at the official NPI Registry.