Ibrez R. Bandukwala, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

46036 Issued in GA

Practice address

1110 W Peachtree St NW Ste 1100
Atlanta, GA 30309

Phone

(404) 892-2131

Fax

(404) 215-9222

NPI assigned

May 16, 2006

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

Electronic endpoints 2

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

Specialty

Internal Medicine

Education

University of North Carolina at Chapel Hill School of Medicine, 1997

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Laureate Medical Group at Northside, LLC 75 clinicians

Select Rehabilitation, LLC 1,935 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Northside Hospital Hospital, Atlanta, GA, CCN 110161
• Piedmont Hospital, Inc Hospital, Atlanta, GA, CCN 110083
• Northside Hospital Forsyth Hospital, Cumming, GA, CCN 110005
• Saint Joseph'S Hospital of Atlanta, Inc Hospital, Atlanta, GA, CCN 110082
• Northside Hospital Cherokee Hospital, Canton, GA, CCN 110008
• Wellstar Windy Hill Hospital Long-term care hospital, Marietta, GA, CCN 112007

Merit-based Incentive Payment System (MIPS)

Final score

80.89 of 100Reported as group

Quality

76.16

Promoting interoperability

88

Improvement activities

40

Cost

70.16

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ibrezbandukwala@lmg.allscriptsdirect.net

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.

• Laureate Medical Group at Northside LLC

  • Internal Medicine Physician
  • Atlanta, GA
  • NPI 1811037336

  GA, Internal Medicine

  Medicare reassignment Care Compare group NPD
• Select Rehabilitation, LLC

  • Rehabilitation Clinic/Center
  • Glenview, IL
  • NPI 1346368248
  Care Compare group

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Kennestone Hospital, Inc.

  • Long Term Care Hospital
  • Marietta, GA
  • NPI 1700853041

  Long-term care hospital

  Care Compare affiliation
• Northside Hospital, Inc.

  • General Acute Care Hospital
  • Canton, GA
  • NPI 1225050396

  Hospital

  Care Compare affiliation
• Northside Hospital, Inc.

  • General Acute Care Hospital
  • Cumming, GA
  • NPI 1376574277

  Hospital

  Care Compare affiliation
• Northside Hospital, Inc.

  • General Acute Care Hospital
  • Atlanta, GA
  • NPI 1457396079

  Hospital

  Care Compare affiliation
• Piedmont Hospital, Inc

  • General Acute Care Hospital
  • Atlanta, GA
  • NPI 1962461681

  Hospital

  Care Compare affiliation
• Saint Josephs Hospital of Atlanta Inc

  • General Acute Care Hospital
  • Atlanta, GA
  • NPI 1679664395

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1147737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605744000000",
    "number": "1720030109",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6600 PEACHTREE DUNWOODY RD STE 325",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303286773",
            "telephone_number": "404-876-1906",
            "fax_number": "404-215-9222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1110 W PEACHTREE ST NW STE 1100",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "30309",
            "telephone_number": "404-892-2131",
            "fax_number": "404-215-9222"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6135 Barfield Rd Ste 200",
            "address_purpose": "LOCATION",
            "city": "Atlanta",
            "state": "GA",
            "postal_code": "303284308",
            "country_code": "US",
            "telephone_number": "404-256-8500",
            "fax_number": "404-256-8506",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BANDUKWALA",
        "first_name": "IBREZ",
        "middle_name": "R.",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-16",
        "last_updated": "2020-11-19",
        "certification_date": "2020-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "46036",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ibrezbandukwala@lmg.allscriptsdirect.net",
            "affiliation": "N",
            "endpointDescription": "direct address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "direct edge",
            "address_1": "1110 W Peachtree St NW Ste 1100",
            "city": "Atlanta",
            "state": "GA",
            "country_code": "US",
            "postal_code": "30309",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ibrezbandukwala@lmg.allscriptsdirect.net",
            "affiliation": "N",
            "endpointDescription": "direct address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "direct edge",
            "address_1": "6135 Barfield Rd Ste 200",
            "city": "Atlanta",
            "state": "GA",
            "country_code": "US",
            "postal_code": "303284308",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Benjamin George Banapoor, MD
• Julie Beth Banares, NP
• Ephrem Belete Bancha, MD
• Clinton Bancroft, CRNA
• Steven Band
• Nazia Quresh Bandukwala, D.O.
• Bishakha Bandyopadhyay, PHARMD
• Margarete Frances Bane
• Candace Moon Banes, FNP-C
• Jasmine Bang

• All providers in Atlanta, GA
• Internal Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2020; 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.