NPIMap

Individual provider Active NPI

Kishor Bhurabhai Sadaria, M.D.

  • Internal Medicine Physician
  • Marietta, GA
National Provider Identifier
1821288713
Registry record updated Dec 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
063607 Issued in GA
Practice address
677 Church St NE
Marietta, GA 30060-1101
Phone
(770) 793-7750
Fax
(770) 793-7755
NPI assigned
Jul 27, 2007
Last updated
Dec 18, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 063607 GA Primary

Addresses

Primary practice location

677 Church St NE
Marietta, GA 30060-1101

Mailing address

3169 Capriole Dr NE
Marietta, GA 30062-0300
Phone (678) 764-5419

Other practice location 1

1035 Red Bud Rd NE
Calhoun, GA 30701-6010
Phone (706) 879-4776

Other identifiers 1

IdentifierTypeStateIssuer
1255528949MedicaidAL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100504000467 GA Practitioner - HospitalistPractitioner - Internal Medicine 7810077955 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
HospitalistAlso: Internal Medicine
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Adventist Health System Georgia IncGroup PAC ID 4486568037, 247 clinicians
Wellstar Medical Group LLCGroup PAC ID 6709065402, 3,059 clinicians

Practice addresses (Care Compare)

1035 Red Bud Rd NE
Calhoun, GA 30701-6010

2518 Jimmy Lee Smith Pkwy
Hiram, GA 30141-2068
Phone (770) 732-4022

3000 Hospital Blvd
Roswell, GA 30076-4915
Phone (770) 751-2912

5150 Stilesboro N W Rd
Suite 220
Kennesaw, GA 30152-7742
Phone (770) 424-8222

625 Church Nest
Marietta, GA 30060-1101
Phone (770) 422-2004

677 Church Nest
Marietta, GA 30060-1101

677 Church St NE
Suite 100P
Marietta, GA 30060-1101
Phone (470) 793-8585

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
83.79 of 100Reported as group
Quality
68.23
Promoting interoperability
100
Improvement activities
40
Cost
74.67

Merit-based Incentive Payment System (MIPS)

Final score
93.93 of 100Reported as apm
Quality
82.14
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
063607GAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wellstar Medical Group, LLC CurrentSince Aug 10, 2015 Accepting new patients
Wellstar Medical Group, LLC CurrentSince Aug 10, 2015 Accepting new patients
Wellstar Medical Group, LLC Current Accepting new patients
Adventist Health System Georgia Inc CurrentSince Jul 1, 2012 Accepting new patients
Hospital Physician Services - Southeast Professional Corporation CurrentSince Aug 1, 2013 Accepting new patients
Redmond Hospital Services LLC Past Accepting new patients
Carilion Medical Center Past Accepting new patients
Kennestone Hospital, Inc. Past Accepting new patients
Mount Lassen Emergency Physicians LLC Past Accepting new patients
New York Em-III Medical Services, PC Internal Medicine Past Accepting new patients

Locations

1035 Red Bud Rd NE
Calhoun, GA 30701
Phone (706) 602-7800

5150 Stilesboro Rd NW
Ste 120
Kennesaw, GA 30152
Phone (678) 354-0230

5150 Stilesboro Rd NW
Ste 220
Kennesaw, GA 30152
Phone (770) 424-8222

677 Church St NE
Marietta, GA 30060
Phone (770) 793-5435

501 Redmond Rd NW
Rome, GA 30165
Phone (706) 291-0291

501 Redmond Rd NW
Fl 6
Rome, GA 30165
Phone (706) 368-8452

801 W Gordon St
Thomaston, GA 30286
Phone (706) 647-4371

Interoperability endpoints

  • Direct secure messaging: ksadaria110906@directwellstar.org
  • Direct secure messaging: ksadaria661748@adventhealth.direct-ci.com

Organizations & group practices 10

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 5

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": "1185494400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702857600000",
    "number": "1821288713",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3169 CAPRIOLE DR NE",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300620300",
            "telephone_number": "678-764-5419"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "677 CHURCH ST NE",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300601101",
            "telephone_number": "770-793-7750",
            "fax_number": "770-793-7755"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1035 Red Bud Rd NE",
            "address_purpose": "LOCATION",
            "city": "Calhoun",
            "state": "GA",
            "postal_code": "307016010",
            "country_code": "US",
            "telephone_number": "706-879-4776",
            "fax_number": "706-879-4781",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SADARIA",
        "first_name": "KISHOR",
        "middle_name": "BHURABHAI",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-07-27",
        "last_updated": "2023-12-18",
        "certification_date": "2023-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "063607",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1255528949",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Marietta, GA

Sources for this page

Verify at the official NPI Registry.