Individual provider Active NPI

Maida Imtiaz Ahmad, OD

  • Optometrist
  • Canton, GA
National Provider Identifier
1851962724
Registry record updated Jun 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPT003333 Issued in GA
Practice address
201 Kimberly Way Ste 200
Canton, GA 30114-8010
Phone
(678) 381-2020
Fax
(678) 381-2015
NPI assigned
Jul 1, 2021
Last updated
Jun 15, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPT003333 GA Primary

Addresses

Primary practice location

201 Kimberly Way Ste 200
Canton, GA 30114-8010

Mailing address

1300 Peachtree Industrial Blvd Ste 1201
Suwanee, GA 30024-4550
Phone (678) 381-2020

Other practice location 1

1034 Haw Creek Cir Ste 100
Cumming, GA 30041-6513
Phone (404) 989-0099

Other identifiers 1

IdentifierTypeStateIssuer
OPT003333OtherGAPROFESSIONAL LICENSE

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220707002352 GA Practitioner - Optometry 1951781988 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Emory University School of Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Milan Eye LLCGroup PAC ID 2668519109, 21 clinicians

Practice addresses (Care Compare)

201 Kimberly Way
Suite 200
Canton, GA 30114-8010
Phone (678) 381-2020

Merit-based Incentive Payment System (MIPS)

Final score
84.14 of 100Reported as group
Quality
94
Promoting interoperability
71
Improvement activities
40
Cost
77.3

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Milan Eye LLC CurrentSince Jun 1, 2022 Accepting new patients
Alpharetta Eye Surgery Center LLC Past Accepting new patients
Buford Eye Surgery Center Past Accepting new patients

Locations

201 Kimberly Way
Ste 200
Canton, GA 30114

3775 Roswell Rd
Ste 100
Marietta, GA 30062

1300 Peachtree Industrial Blvd
Ste 1201
Suwanee, GA 30024
Phone (770) 614-6266

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1625097600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655251200000",
    "number": "1851962724",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 PEACHTREE INDUSTRIAL BLVD STE 1201",
            "city": "SUWANEE",
            "state": "GA",
            "postal_code": "300244550",
            "telephone_number": "678-381-2020",
            "fax_number": "678-381-2015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 KIMBERLY WAY STE 200",
            "city": "CANTON",
            "state": "GA",
            "postal_code": "301148010",
            "telephone_number": "678-381-2020",
            "fax_number": "678-381-2015"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1034 Haw Creek Cir Ste 100",
            "address_purpose": "LOCATION",
            "city": "Cumming",
            "state": "GA",
            "postal_code": "300416513",
            "country_code": "US",
            "telephone_number": "404-989-0099",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AHMAD",
        "first_name": "MAIDA",
        "middle_name": "IMTIAZ",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-01",
        "last_updated": "2022-06-15",
        "certification_date": "2022-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "GA",
            "license": "OPT003333",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROFESSIONAL LICENSE",
            "identifier": "OPT003333",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Canton, GA

Sources for this page

Verify at the official NPI Registry.