Individual provider Active NPI

Joel I Kirson, M.D.

  • Psychiatry Physician
  • Roswell, GA
National Provider Identifier
1689643512
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
040125 Issued in GA
Practice address
401 Bombay LN
Roswell, GA 30076-5826
Phone
(770) 664-1920
Fax
(888) 251-5653
NPI assigned
Mar 14, 2006
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 040125 GA Primary

Addresses

Primary practice location

401 Bombay LN
Roswell, GA 30076-5826

Mailing address

401 Bombay Lane
Roswell, GA 30076-5829
Phone (770) 664-1920

Other identifiers 1

IdentifierTypeStateIssuer
00656279AMedicaidGA

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
I20091013000050 GA Practitioner - Psychiatry 9335285980 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
University of Maryland School of Medicine, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Carenow Services, LLCGroup PAC ID 2163561259, 36 clinicians

Practice addresses (Care Compare)

401 Bombay LN
Roswell, GA 30076-5826
Phone (770) 664-1920

Merit-based Incentive Payment System (MIPS)

Final score
49.38 of 100Reported as group
Quality
4.35
Promoting interoperability
0
Improvement activities
40
Cost
76.92

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
040125GAMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Carenow Services, LLC CurrentSince Oct 16, 2009 Accepting new patients
Black Bear Treatment Center LLC Past Accepting new patients

Locations

401 Bombay Ln
Roswell, GA 30076
Phone (770) 664-1920

901 Bombay Ln
Roswell, GA 30076
Phone (770) 664-1920

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1142294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1689643512",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 BOMBAY LANE",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "300765829",
            "telephone_number": "770-664-1920",
            "fax_number": "888-251-5653"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 BOMBAY LN",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "300765826",
            "telephone_number": "770-664-1920",
            "fax_number": "888-251-5653"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIRSON",
        "first_name": "JOEL",
        "middle_name": "I",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-14",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "GA",
            "license": "040125",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00656279A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Roswell, GA

Sources for this page

Verify at the official NPI Registry.