Individual provider Active NPI

Soham Mahadevia, M.D.

  • Diagnostic Radiology Physician
  • Atlanta, GA
National Provider Identifier
1821222894
Registry record updated May 6, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
71362 Issued in GA
Practice address
1364 Clifton Rd NE
Room D125A
Atlanta, GA 30322-1059
Phone
(404) 712-4686
NPI assigned
May 6, 2009
Last updated
May 6, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 6, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 71362 GA Primary

Addresses

Primary practice location

1364 Clifton Rd NE
Room D125A
Atlanta, GA 30322-1059

Mailing address

5605 Glenridge Dr Ste 325
Atlanta, GA 30342-1365
Phone (678) 553-7783

Other practice location 1

1000 Johnson Ferry Rd
Atlanta, GA 30342-1606
Phone (404) 851-6323

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
I20140620002201 GA Practitioner - Diagnostic Radiology 9537383187 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Albert Einstein College of Medicine of Yeshiva University, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northside Radiology Associates LLCGroup PAC ID 4486555398, 381 clinicians

Practice addresses (Care Compare)

1000 Johnson Ferry Rd
Atlanta, GA 30342-1606
Phone (404) 662-2438

1000 Johnson Ferry Rd NE
Atlanta, GA 30342-1606
Phone (404) 662-2438

2173 Abby LN NE
Atlanta, GA 30345-3516
Phone (404) 662-2438

2859 N Decatur Rd
Decatur, GA 30033-5911
Phone (404) 851-6577

300 Valley Brook Way NE
Atlanta, GA 30342-3377
Phone (404) 662-2438

314 Valley Brook Way NE
Atlanta, GA 30342-3377
Phone (404) 662-2438

4800 Olde Towne Pkwy
Suite 100
Marietta, GA 30068-4357
Phone (404) 851-6577

758 Old Norcross Rd
Suite 100
Lawrenceville, GA 30046-3386
Phone (404) 662-2438

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
96.75 of 100Reported as group
Quality
96.18
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Northside Radiology Associates LLC Diagnostic Radiology CurrentSince Apr 1, 2015 Accepting new patients
Emory Medical Care Foundation Inc Current Accepting new patients
Emory Medical Care Foundation Inc Diagnostic Radiology CurrentSince Jul 1, 2014 Accepting new patients
The Emory Clinic Inc Diagnostic Radiology CurrentSince Jul 1, 2014 Accepting new patients

Locations

100 Galleria Pkwy SE
Ste 1450
Atlanta, GA 30339
Phone (770) 952-8899

1365 Clifton Rd NE
Atlanta, GA 30322
Phone (404) 778-7525

80 Jesse Hill Jr Dr SE
Atlanta, GA 30303
Phone (404) 616-4370

1000 Johnson Ferry Rd
Sandy Springs, GA 30342
Phone (404) 851-8737

5605 Glenridge Dr
Ste 325
Sandy Springs, GA 30342
Phone (678) 553-7783

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

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": "1241568000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1557100800000",
    "number": "1821222894",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5605 GLENRIDGE DR STE 325",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303421365",
            "telephone_number": "678-553-7783",
            "fax_number": "678-553-7793"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1364 CLIFTON RD NE",
            "address_2": "ROOM D125A",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303221059",
            "telephone_number": "404-712-4686"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1000 Johnson Ferry Rd",
            "address_purpose": "LOCATION",
            "city": "Atlanta",
            "state": "GA",
            "postal_code": "303421606",
            "country_code": "US",
            "telephone_number": "404-851-6323",
            "fax_number": "404-303-3747",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MAHADEVIA",
        "first_name": "SOHAM",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-05-06",
        "last_updated": "2019-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "GA",
            "license": "71362",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.