NPIMap

Organization Active NPI

Advanced Urology Institute of Georgia, LLC

  • Urology Physician
  • Dallas, GA
National Provider Identifier
1811846348
Registry record updated Sep 23, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
Legal business name
ADVANCED UROLOGY INSTITUTE OF GEORGIA, LLC
Practice address
2713 Charles Hardy Pkwy BLDG 100
Ste 122
Dallas, GA 30157-9470
Phone
(678) 344-8900
Fax
(678) 666-5201
NPI assigned
Jan 27, 2026
Last updated
Sep 23, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2026

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

Authorized official

Name
Beemal Shah
Title
Ceo
Phone
(706) 951-8657

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X NU Primary

Addresses

Primary practice location

2713 Charles Hardy Pkwy BLDG 100
Ste 122
Dallas, GA 30157-9470

Mailing address

1551 Janmar Rd
Snellville, GA 30078-5606
Phone (470) 579-5600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110926000393 GA Part B Supplier - Clinic/Group Practice 1759552607 Receives reassigned benefits from 121 practitioners
16 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Conyers, GA; Snellville, GA; Roswell, GA; Marietta, GA; Lawrenceville, GA; Johns Creek, GA; Jasper, GA; Decatur, GA…

Other NPIs on the same Medicare enrollment 16

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 16

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
11D2338686Advanced Urology Institute of Georgia, PC2713 Charles Hardy Parkway, BLDG 100, Suite 122, Dallas, GA 30157Certificate of waiverFeb 15, 2028

National Provider Directory

National Provider Directory
Tax ID family
Advanced Urology Institute of Georgia PC16 organizations share this tax ID, including this one

Other organizations with this tax ID 15

Organizations that report the same tax identification number in the National Provider Directory.

View all 15

Locations

1800 Peachtree St NW
Ste 700
Atlanta, GA 30309
Phone (404) 350-7966

501 Crownpointe Way
Lawrenceville, GA 30046
Phone (404) 341-6583

1800 Tree Ln
Ste 280
Snellville, GA 30078
Phone (404) 919-4876

Practitioners & affiliated clinicians

Practitioners 142

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 142

NPI Registry JSON

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

{
    "created_epoch": "1769472000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1790121600000",
    "number": "1811846348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1551 JANMAR RD",
            "city": "SNELLVILLE",
            "state": "GA",
            "postal_code": "300785606",
            "telephone_number": "470-579-5600",
            "fax_number": "678-691-0506"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2713 CHARLES HARDY PKWY BLDG 100",
            "address_2": "STE 122",
            "city": "DALLAS",
            "state": "GA",
            "postal_code": "301579470",
            "telephone_number": "678-344-8900",
            "fax_number": "678-666-5201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED UROLOGY INSTITUTE OF GEORGIA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-01-27",
        "last_updated": "2026-09-23",
        "certification_date": "2026-09-23",
        "status": "A",
        "authorized_official_last_name": "SHAH",
        "authorized_official_first_name": "BEEMAL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "706-951-8657"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2026; 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.