Individual provider Active NPI

Alan M Kozarsky, MD

  • Ophthalmology Physician
  • Atlanta, GA
National Provider Identifier
1700840147
Registry record updated Oct 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
023619 Issued in GA
Practice address
3193 Howell Mill Rd NW Ste 115
Atlanta, GA 30327-2100
Phone
(404) 350-1425
Fax
(404) 350-1429
NPI assigned
Apr 13, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Cornea and External Diseases Specialist Physician 207WX0120X 023619 GA
Ophthalmology Physician 207W00000X 023619 GA Primary

Addresses

Primary practice location

3193 Howell Mill Rd NW Ste 115
Atlanta, GA 30327-2100

Mailing address

3225 Cumberland Blvd SE
Suite 900
Atlanta, GA 30339-6407
Phone (404) 351-2220

Other identifiers 1

IdentifierTypeStateIssuer
000246991CMedicaidGA

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
I20100915000001 GA Practitioner - Ophthalmology 2860517885 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
023619GAMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Eca Optical, LLC CurrentSince Apr 10, 2013 Accepting new patients
Eye Consultants of Atlanta, PC Ophthalmology CurrentSince Apr 10, 2013 Accepting new patients

Locations

3193 Howell Mill Rd NW
Ste 115
Atlanta, GA 30327
Phone (404) 350-1425

3225 Cumberland Blvd SE
Ste 900
Atlanta, GA 30339
Phone (770) 394-4568

5445 Meridian Mark Rd
Ste 220
Sandy Springs, GA 30342
Phone (404) 255-2419

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": "1144886400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602547200000",
    "number": "1700840147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3225 CUMBERLAND BLVD SE",
            "address_2": "SUITE 900",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303396407",
            "telephone_number": "404-351-2220",
            "fax_number": "404-355-5624"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3193 HOWELL MILL RD NW STE 115",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303272100",
            "telephone_number": "404-350-1425",
            "fax_number": "404-350-1429"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOZARSKY",
        "first_name": "ALAN",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-13",
        "last_updated": "2020-10-13",
        "certification_date": "2020-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207WX0120X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Cornea and External Diseases Specialist",
            "state": "GA",
            "license": "023619",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "GA",
            "license": "023619",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000246991C",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.