Pediatric and Adult Surgery Center of Atlanta LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

055430 Issued in GA

Legal business name

PEDIATRIC AND ADULT SURGERY CENTER OF ATLANTA LLC

Practice address

2061 Peachtree Rd NE Ste 300-a
Atlanta, GA 30309-1447

Phone

(678) 483-8833

NPI assigned

Aug 22, 2018

Organization subpart

No

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

Authorized official

Name

Dr. Shatul Parikh, MDNPI 1447434915

Title

Medical Director

Phone

(678) 483-8833

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Listed as

Pediatric and Adult Surgery Center of Atlanta LLCCCN 11C0001504

Medicare certification status

ActiveFrom the Provider of Services file

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Shatul L. Parikh, M.D.

  • Otolaryngology Physician
  • Marietta, GA
  • NPI 1447434915
  Medicare reassignment NPD Authorized official
• Avani Patel Ingley, MD

  • Otolaryngology Physician
  • Marietta, GA
  • NPI 1134305030
  NPD (past)
• Ryan Matthew Kauffman, M.D.

  • Otolaryngology Physician
  • Marietta, GA
  • NPI 1881873271
  NPD (past)
• Hannan Asim Qureshi, M.D.

  • Otolaryngology Physician
  • Marietta, GA
  • NPI 1942691910
  NPD (past)

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

{
    "created_epoch": "1534896000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1534896000000",
    "number": "1750862389",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "960 WOODSTOCK PKWY STE 101",
            "city": "WOODSTOCK",
            "state": "GA",
            "postal_code": "301884866",
            "telephone_number": "678-483-8833",
            "fax_number": "678-483-8809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2061 PEACHTREE RD NE STE 300-A",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303091447",
            "telephone_number": "678-483-8833"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC AND ADULT SURGERY CENTER OF ATLANTA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-08-22",
        "last_updated": "2018-08-22",
        "status": "A",
        "authorized_official_last_name": "PARIKH",
        "authorized_official_first_name": "SHATUL",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "678-483-8833",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "GA",
            "license": "055430",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Katylia Peck, RN
• Jennifer Young Pecot, CPNP
• Millicent J Pedersen
• Nicole Pederson
• Pedia Doc Children'S Med Ctr
• Pediatric Audiology of Atlanta
• Pediatric Cardiology Services LLC
• Pediatric Developmental Services
• Pediatric Ear, Nose, & Throat of Atlanta, PC
• Pediatric Endocrine Associates II LLC

• Ambulatory Surgical Clinic/Center in Atlanta, GA
• Providers in Atlanta, GA by specialty
• Ambulatory Surgical Clinic/Center in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.