NPIMap

Individual provider Active NPI

Shaan Patel, DO

  • Internal Medicine Physician
  • Duluth, GA
National Provider Identifier
1841827631
Registry record updated Oct 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
94786 Issued in GA
Practice address
3500 McClure Bridge Rd
Duluth, GA 30096-3131
Phone
(770) 476-3636
Fax
(770) 476-5845
NPI assigned
Mar 24, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2024

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 94786 GA Primary

Addresses

Primary practice location

3500 McClure Bridge Rd
Duluth, GA 30096-3131

Mailing address

3500 McClure Bridge Rd
Duluth, GA 30096-3131
Phone (770) 476-3636

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
I20231010002012 GA Practitioner - Internal Medicine 1557784873 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northeast Georgia Diagnostic Associates and Clinic, LLCGroup PAC ID 1951655737, 81 clinicians

Practice addresses (Care Compare)

2800 Buford Dr
Suite 200
Buford, GA 30519-5107
Phone (678) 344-3744

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
78.26 of 100Reported as group
Quality
71.9
Promoting interoperability
75
Improvement activities
40
Cost
76.47

Merit-based Incentive Payment System (MIPS)

Final score
93.24 of 100Reported as group
Quality
73.72
Promoting interoperability
100
Improvement activities
40
Cost
75.22

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11811GAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Northeast Georgia Diagnostic Associates and Clinic, LLC CurrentSince Jun 10, 2024 Accepting new patients
Emory Medical Care Foundation Inc CurrentSince Nov 1, 2023 Accepting new patients
Emory Medical Care Foundation Inc Internal Medicine CurrentSince Nov 1, 2023 Accepting new patients
Northeast Georgia Diagnostic Clinic LLC PastSince Jun 10, 2024 Accepting new patients

Locations

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

341 Ponce de Leon Ave NE
Atlanta, GA 30308
Phone (404) 616-2440

2800 Buford Dr
Ste 200
Buford, GA 30519
Phone (678) 344-3744

3500 McClure Bridge Rd
Duluth, GA 30096
Phone (770) 476-3636

1250 Jesse Jewell Pkwy SE
Ste 400
Gainesville, GA 30501
Phone (470) 228-7507

1240 Jesse Jewell Pkwy SE
Ste 500
Gainesville, GA 30501

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

2220 Wisteria Dr
Ste 102
Snellville, GA 30078
Phone (470) 679-1200

Interoperability endpoints

  • Direct secure messaging: shaanpatel@negaidx.allscriptsdirect.net

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 and National Provider Directory roles.

Hospital & facility affiliations 6

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": "1585008000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727740800000",
    "number": "1841827631",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3500 MCCLURE BRIDGE RD",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "300963131",
            "telephone_number": "770-476-3636",
            "fax_number": "770-476-5845"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3500 MCCLURE BRIDGE RD",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "300963131",
            "telephone_number": "770-476-3636",
            "fax_number": "770-476-5845"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "SHAAN",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-03-24",
        "last_updated": "2024-10-01",
        "certification_date": "2024-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "94786",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Duluth, GA

Sources for this page

Verify at the official NPI Registry.