Individual provider Active NPI

Fares Hosseinzadeh

  • Family Medicine Physician
  • Alpharetta, GA
National Provider Identifier
1760123046
Registry record updated Dec 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
105392 Issued in GA
Practice address
11180 State Bridge Rd Ste 404
Alpharetta, GA 30022-7484
Phone
(770) 252-2220
NPI assigned
Apr 2, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 105392 GA Primary

Addresses

Primary practice location

11180 State Bridge Rd Ste 404
Alpharetta, GA 30022-7484

Mailing address

11180 State Bridge Rd Ste 404
Johns Creek, GA 30022-7484
Phone (770) 252-2220

Other practice location 1

1101 Nortec Dr SE
Conyers, GA 30013-5835
Phone (678) 374-7514

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
I20251110000001 GA Practitioner - Family Practice 8123494457 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aylo Health, LLCGroup PAC ID 8022901925, 112 clinicians

Practice addresses (Care Compare)

1101 Nortec Dr SE
Conyers, GA 30013-5835
Phone (770) 914-0116

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
105392GAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Chiefhoss LLC CurrentSince Nov 7, 2025 Accepting new patients
Aylo Health, LLC CurrentSince Oct 1, 2025 Accepting new patients
Aylo Health, LLC Family Medicine CurrentSince Oct 1, 2025 Accepting new patients
Aylo Health, LLC Family Medicine Current Accepting new patients
Benning Hospitalist Services, LLC CurrentSince Oct 10, 2025 Accepting new patients
Muscogee Hospitalist Services, LLC CurrentSince Oct 10, 2025 Accepting new patients
Aylo Health, LLC Family Medicine Past Accepting new patients
Aylo Health, LLC Family Medicine Past Accepting new patients
Aylo Health, LLC Past Accepting new patients

Locations

3333 Riverwood Pkwy SE
Ste 250
Atlanta, GA 30339
Phone (770) 914-0016

100 Frist Ct
Columbus, GA 31909
Phone (706) 494-2100

710 Center St
Columbus, GA 31901
Phone (706) 571-1000

1101 Nortec Dr SE
Conyers, GA 30013
Phone (678) 374-7514

11180 State Bridge Rd
Ste 404
Johns Creek, GA 30022
Phone (678) 319-0110

1240 Eagles Landing Pkwy
Ste 110
Stockbridge, GA 30281
Phone (770) 389-3855

145 Eagles Walk
Ste A
Stockbridge, GA 30281
Phone (770) 389-3855

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/DBJIDD/Endpoint/DBJIDD
  • FHIR API: https://api.platform.athenahealth.com/14272/brand/70/csg/1/fhir/r4

Organizations & group practices 9

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.

NPI Registry JSON

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

{
    "created_epoch": "1648857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765756800000",
    "number": "1760123046",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11180 STATE BRIDGE RD STE 404",
            "city": "JOHNS CREEK",
            "state": "GA",
            "postal_code": "300227484",
            "telephone_number": "770-252-2220",
            "fax_number": "855-538-3133"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11180 STATE BRIDGE RD STE 404",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "300227484",
            "telephone_number": "770-252-2220"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1101 Nortec Dr SE",
            "address_purpose": "LOCATION",
            "city": "Conyers",
            "state": "GA",
            "postal_code": "300135835",
            "country_code": "US",
            "telephone_number": "678-374-7514",
            "fax_number": "678-374-7517",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HOSSEINZADEH",
        "first_name": "FARES",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-04-02",
        "last_updated": "2025-12-15",
        "certification_date": "2025-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "105392",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Alpharetta, GA

Sources for this page

Verify at the official NPI Registry.