Individual provider Active NPI

Arash Taheri, M.D.

  • Internal Medicine Physician
  • Atlanta, GA
National Provider Identifier
1780004705
Registry record updated Mar 19, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
83724 Issued in GA
Practice address
1325 Ralph David Abernathy Blvd SW
Atlanta, GA 30310-1649
Phone
(404) 836-0136
Fax
(404) 753-5266
NPI assigned
Apr 17, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 19, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X 2017-01927 NC
Internal Medicine Physician 207R00000X 83724 GA Primary

Addresses

Primary practice location

1325 Ralph David Abernathy Blvd SW
Atlanta, GA 30310-1649

Mailing address

1395 NW 167TH St
Miami Gardens, FL 33169-5710
Phone (404) 836-0136

Other identifiers 1

IdentifierTypeStateIssuer
1780004705MedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, GA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20171113000098 NC Practitioner - Family PracticePractitioner - Peripheral Vascular Disease 3476819293 Reassigns benefits to 1 organization
I20190828003387 GA Practitioner - Family PracticePractitioner - Peripheral Vascular DiseasePractitioner - Undersea and Hyperbaric Medicine 3476819293 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Peripheral Vascular Disease
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
PMR Georgia Holding LLCGroup PAC ID 8426466590, 19 clinicians

Practice addresses (Care Compare)

1325 Ralph David Abernathy Blvd SW
Atlanta, GA 30310-1649
Phone (404) 836-0136

Hospital & facility affiliations

  • Golden Rule Hospice, LLC. Hospice, Alpharetta, GA, CCN 111776

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Cobb Hyperbaric Medicine, Inc Multi-Specialty CurrentSince Jul 1, 2019 Accepting new patients
Vohra Wound Physicians of Ny, PLLC Multi-Specialty CurrentSince Jul 2, 2018 Accepting new patients
Vohra Wound Physicians of FL, LLC Multi-Specialty CurrentSince Aug 1, 2019 Accepting new patients
Bethany Medical Center Multi-Specialty Past Accepting new patients

Locations

1341 Canton Rd
Ste A
Marietta, GA 30066

61 Whitcher St NE
Ste 2150
Marietta, GA 30060
Phone (770) 422-4268

100 Bull St
Ste 200
Savannah, GA 31401
Phone (770) 478-3013

Organizations & group practices 5

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1397692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1584576000000",
    "number": "1780004705",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1395 NW 167TH ST",
            "city": "MIAMI GARDENS",
            "state": "FL",
            "postal_code": "331695710",
            "telephone_number": "404-836-0136"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1325 RALPH DAVID ABERNATHY BLVD SW",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303101649",
            "telephone_number": "404-836-0136",
            "fax_number": "404-753-5266"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAHERI",
        "first_name": "ARASH",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-04-17",
        "last_updated": "2020-03-19",
        "certification_date": "2020-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": "2017-01927",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "83724",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1780004705",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.