Individual provider Active NPI

Amir Ghanipour, OD

  • Optometrist
  • Atlanta, GA
National Provider Identifier
1679199582
Registry record updated Jun 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPT003244 Issued in GA
Practice address
1100 Johnson Fy Rd NE Ste 108
Atlanta, GA 30342-1733
Phone
(404) 531-9988
NPI assigned
Jun 17, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 17, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193200000X MULTI-SPECIALTY GROUP 152W00000X OPT003244 GA Primary

Addresses

Primary practice location

1100 Johnson Fy Rd NE Ste 108
Atlanta, GA 30342-1733

Mailing address

1100 Johnson Fy Rd NE Ste 108
Atlanta, GA 30342-1733
Phone (404) 531-9988

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210218003119 GA Practitioner - Optometry 4688089998

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
94.51 of 100Reported as apm
Quality
80.61
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPT003244GAMDOptometrist

Interoperability endpoints

  • Direct secure messaging: aghanipour@espgep.intellechartdirect.net

NPI Registry JSON

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

{
    "created_epoch": "1592352000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592352000000",
    "number": "1679199582",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 JOHNSON FY RD NE STE 108",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303421733",
            "telephone_number": "404-531-9988"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 JOHNSON FY RD NE STE 108",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303421733",
            "telephone_number": "404-531-9988"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GHANIPOUR",
        "first_name": "AMIR",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-06-17",
        "last_updated": "2020-06-17",
        "certification_date": "2020-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "GA",
            "license": "OPT003244",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.