Gregory Benjamin Ang, MD
Individual provider Active NPI Cardiovascular Disease Physician · Atlanta, GA
NPI 1851593552 · NPPES record last updated Jan 13, 2022
Key facts
- NPI
- 1851593552
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Cardiovascular Disease Physician 207RC0000X
- License
- 59361 (GA)
- Practice address
- 20 Glenlake Pkwy
Kaiser Permanente Glenlake Medical Office
Atlanta, GA 30328-3473 - Phone
- (404) 250-6400
- Fax
- (404) 250-6405
- NPI assigned
- Jun 4, 2007
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 3
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Cardiovascular Disease (Cardiology)
- Education
- Johns Hopkins University School of Medicine, 2000
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- The Southeast Permanente Medical Group
Practice addresses (Care Compare)
20 Glenlake Pkwy
Atlanta, GA 30328-3473
Phone (770) 677-6043
Hospital & facility affiliations
- Saint Joseph'S Hospital of Atlanta, Inc
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in GA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20080327000518 | GA | Practitioner - Cardiovascular Disease (Cardiology) |
7214900679 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 59361 | GA | MD | Cardiovascular Disease Physician |
| 200300550 | NC | MD | Cardiovascular Disease Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Southeast Permanente Medical Group | Current |
Accepting new patients | |
| Saint Josephs Hospital of Atlanta Inc | Past | Accepting new patients | |
| The Medical Group of Saint Joseph'S, LLC | Cardiovascular Disease | Past | Accepting new patients |
Locations
3495 Piedmont Rd NE
Bldg 9
Atlanta, GA 30305
Phone (404) 364-7000
20 Glenlake Pkwy
Sandy Springs, GA 30328
Phone (770) 677-6247
20 Glenlake Pkwy
Ofc
Sandy Springs, GA 30328
Phone (404) 250-6400
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Cardiovascular Disease Physician | 207RC0000X | 200300550 | NC | |
| Cardiovascular Disease Physician | 207RC0000X | 59361 | GA | Yes |
Addresses
Primary practice location
20 Glenlake Pkwy
Kaiser Permanente Glenlake Medical Office
Atlanta, GA 30328-3473
Mailing address
3495 Piedmont Rd NE
The Southeast Permanente Medical Group
Atlanta, GA 30305-1717
Phone (404) 364-7070
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 526802771A | Medicaid | GA | |
| 526802771B | Medicaid | GA |
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| SOAP URL | https://careepiceast.kp.org:14430/Interconnect-prodgam/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq | Health Information Exchange (HIE) | Permanente Medical Group |
Other providers in Atlanta, GA
- Karen J. Andry
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- Anesthesia Beignets and Gumbo
- Anesthesia Services of Atlanta LLC
- Angel Cares
- Angel Heart Hospice and Palliative Care
- Angel Heart Hospice and Palliative Care
- Angel Heart Hospice and Palliative Care Mobile Lab
- Elizabeth Janet Angel
All providers in Atlanta, GA · Cardiovascular Disease Physician in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 13, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.