Individual provider Active NPI

Ahmad Khaldi, M.D.

  • Neurological Surgery Physician
  • Marietta, GA
National Provider Identifier
1679736938
Registry record updated Nov 5, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
License
68224 Issued in GA
Practice address
61 Whitcher Street
Suite 3110
Marietta, GA 30060
Phone
(770) 422-2326
Fax
(770) 422-7797
NPI assigned
Jul 8, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 5, 2019

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

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X MD039565 DC
General Acute Care Hospital 282N00000X 125046943 IL
General Acute Care Hospital 282N00000X 0101249516 VA
General Acute Care Hospital 282N00000X FK1937359 DC
General Acute Care Hospital 282N00000X D0072280 MD
Neurological Surgery Physician 207T00000X 68224 GA Primary

Addresses

Primary practice location

61 Whitcher Street
Suite 3110
Marietta, GA 30060

Mailing address

61 Whitcher St NE Ste 3110
Marietta, GA 30060-1179
Phone (770) 422-2326

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address akhaldi30799@directwellstar.org

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
I20120904000479 GA Practitioner - Neurosurgery 3577741040 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurosurgery
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Wellstar Medical Group LLCGroup PAC ID 6709065402, 3,059 clinicians

Practice addresses (Care Compare)

61 Whitcher St
Suite 3110
Marietta, GA 30060-1176
Phone (770) 422-2326

Hospital & facility affiliations

  • Wellstar Kennestone Regional Medical Center Hospital, Marietta, GA, CCN 110035
  • Wellstar Paulding Medical Center Hospital, Hiram, GA, CCN 110042
  • Wellstar Cobb Medical Center Hospital, Austell, GA, CCN 110143
  • Wellstar North Fulton Medical Center Hospital, Roswell, GA, CCN 110198
  • Wellstar West Georgia Medical Center Hospital, Lagrange, GA, CCN 110016
  • Wellstar Windy Hill Hospital Long-term care hospital, Marietta, GA, CCN 112007

Merit-based Incentive Payment System (MIPS)

Final score
93.93 of 100Reported as apm
Quality
82.14
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
68224GAMDNeurological Surgery Physician
FK1937359DCMDGeneral Acute Care Hospital
125046943ILMDGeneral Acute Care Hospital
D0072280MDMDGeneral Acute Care Hospital
0101249516VAMDGeneral Acute Care Hospital

Practice roles

OrganizationSpecialtyStatusNew patients
Wellstar Medical Group, LLC CurrentSince Sep 1, 2012 Accepting new patients
Wellstar Medical Group, LLC Current Accepting new patients
Wellstar Medical Group, LLC CurrentSince Sep 1, 2012 Accepting new patients
Kennestone Hospital, Inc. General Acute Care Hospital Past Accepting new patients

Locations

5150 Stilesboro Rd NW
Ste 120
Kennesaw, GA 30152
Phone (678) 354-0230

5150 Stilesboro Rd NW
Ste 220
Kennesaw, GA 30152
Phone (770) 424-8222

61 Whitcher St NE
Ste 3110
Marietta, GA 30060
Phone (770) 422-2326

Interoperability endpoints

  • Direct secure messaging: akhaldi30799@directwellstar.org

Organizations & group practices 4

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 6

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": "1215475200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572912000000",
    "number": "1679736938",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "61 WHITCHER ST NE STE 3110",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300601179",
            "telephone_number": "770-422-2326",
            "fax_number": "770-422-7797"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "61 WHITCHER STREET",
            "address_2": "SUITE 3110",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "30060",
            "telephone_number": "770-422-2326",
            "fax_number": "770-422-7797"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHALDI",
        "first_name": "AHMAD",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-07-08",
        "last_updated": "2019-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "DC",
            "license": "MD039565",
            "primary": false
        },
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "IL",
            "license": "125046943",
            "primary": false
        },
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "VA",
            "license": "0101249516",
            "primary": false
        },
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "DC",
            "license": "FK1937359",
            "primary": false
        },
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "MD",
            "license": "D0072280",
            "primary": false
        },
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "GA",
            "license": "68224",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "akhaldi30799@directwellstar.org",
            "affiliation": "N",
            "address_1": "61 Whitcher Street",
            "address_2": "Suite 3110",
            "city": "Marietta",
            "state": "GA",
            "country_code": "US",
            "postal_code": "30060",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Marietta, GA

Sources for this page

Verify at the official NPI Registry.