Hiroyuki Tada

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

RN207467 Issued in GA

Practice address

4700 Nelson Brogdon Blvd Ste 250
Buford, GA 30518-5415

Phone

(678) 341-6380

Fax

(678) 288-1064

NPI assigned

Feb 17, 2016

Last updated

May 9, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA, NY2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Specialty

Nurse Practitioner

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Southeast Medical Group, P.C.Group PAC ID 3577559673, 139 clinicians

Open Door Family Medical Center IncGroup PAC ID 7113835380, shared by 7 NPIs, 61 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/DIJIBA

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.

• Southeast Medical Group, P.C.

  dba North Atlanta Primary Care, P.C.

  • Family Medicine Physician
  • Alpharetta, GA
  • NPI 1235296054
  Medicare reassignment Care Compare group NPD
• Peachtree Immediate Care FP, LLC

  • Family Medicine Physician
  • Hiram, GA
  • NPI 1437194156
  Medicare reassignment NPD
• TLC of Georgia LLC

  dba The Little Clinic

  • Family Nurse Practitioner
  • Jefferson, GA
  • NPI 1750677241
  NPD

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

{
    "created_epoch": "1455667200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715212800000",
    "number": "1710346895",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2620 ELM HILL PIKE",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372143108",
            "telephone_number": "615-425-4200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4700 NELSON BROGDON BLVD STE 250",
            "city": "BUFORD",
            "state": "GA",
            "postal_code": "305185415",
            "telephone_number": "678-341-6380",
            "fax_number": "678-288-1064"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TADA",
        "first_name": "HIROYUKI",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-02-17",
        "last_updated": "2024-05-09",
        "certification_date": "2024-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN207467",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Synergy Construction (Synergy Soutions)
• Quynh Anh Ta, O.D.
• Dina Taarea, D.O.
• Tabitha's House, Inc.
• Paula Renee Tabor, C.N.A.
• Nina Talukdar, MD, MPH
• Andrew Michael Tarr, M.D.
• Kelly Tassitano, M.ED., CCC-SLP
• Priyanka Tayee, DDS
• Alexcia Taylor, BS

• Family Nurse Practitioner in Buford, GA
• Providers in Buford, GA by specialty
• Family Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.