NPIMap

Individual provider Active NPI

Shahriar Sedghi, M.D.

  • Gastroenterology Physician
  • Macon, GA
National Provider Identifier
1689659260
Registry record updated May 2, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
037678 Issued in GA
Practice address
610 Third Street
Ste 204
Macon, GA 31201
Phone
(478) 477-3936
Fax
(478) 742-2040
NPI assigned
Dec 7, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 2, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 037678 GA Primary

Addresses

Primary practice location

610 Third Street
Ste 204
Macon, GA 31201

Mailing address

610 Third Street
Ste 204
Macon, GA 31201
Phone (478) 477-3936

Other identifiers 2

IdentifierTypeStateIssuer
00604381AMedicaidGA
P00077251OtherGAMEDICARE RAILROAD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050627000075 GA Practitioner - GastroenterologyPractitioner - Internal MedicinePractitioner - Emergency Medicine 5991601056 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Gastroenterology Associates of Central Ga LLCGroup PAC ID 6901702059, 17 clinicians

Practice addresses (Care Compare)

260 W Clinton St
Suite 3
Gray, GA 31032-5430
Phone (478) 464-2600

610 3Rd St
Macon, GA 31201-3262
Phone (478) 464-2600

6103 Rd St
Suite 202
Macon, GA 31201-3262
Phone (478) 464-2600

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy421
Upper gastrointestinal (GI) endoscopy for acid reflux492

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
037678GAMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Endoscopy Center of Middle Georgia LLC Current Accepting new patients
Gastroenterology Associates of Central Ga, LLC CurrentSince Oct 1, 2003 Accepting new patients
Endoscopy ASC of Middle Georgia LLC PastSince Aug 1, 2022 Accepting new patients
Hospital Authority of the City of Bainbridge and Decatur County Past Accepting new patients
Eclipse Anesthesia LLC PastSince Mar 31, 2008 Accepting new patients
Synergetic Healings LLC Past Accepting new patients

Locations

260 W Clinton St
Ste 3
Gray, GA 31032
Phone (478) 607-2514

610 3rd St
Ste 202
Macon, GA 31201
Phone (478) 216-7378

610 3rd St
Macon, GA 31201

610 3rd St
Ste 100
Macon, GA 31201
Phone (478) 745-8205

770 Pine St
Ste 270
Macon, GA 31201
Phone (478) 742-2474

610 3rd St
Ste 204
Macon, GA 31201
Phone (478) 477-3936

610 3rd St
Ste 206
Macon, GA 31201

Interoperability endpoints

  • Direct secure messaging: shahriar.sedghi@gaocg.eclinicaldirectplus.com

Organizations & group practices 6

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": "1133913600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1525219200000",
    "number": "1689659260",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "610 THIRD STREET",
            "address_2": "STE 204",
            "city": "MACON",
            "state": "GA",
            "postal_code": "31201",
            "telephone_number": "478-477-3936",
            "fax_number": "478-742-2040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "610 THIRD STREET",
            "address_2": "STE 204",
            "city": "MACON",
            "state": "GA",
            "postal_code": "31201",
            "telephone_number": "478-477-3936",
            "fax_number": "478-742-2040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEDGHI",
        "first_name": "SHAHRIAR",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-07",
        "last_updated": "2018-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "GA",
            "license": "037678",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00604381A",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "P00077251",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Macon, GA

Sources for this page

Verify at the official NPI Registry.