NPIMap

Individual provider Active NPI

Shaaz Syed Fareed

  • Family Medicine Physician
  • Acworth, GA
National Provider Identifier
1861072746
Registry record updated Jun 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
99133 Issued in GA
Practice address
4791 S Main St Ste 100
Acworth, GA 30101-5324
Phone
(404) 251-1600
NPI assigned
Apr 13, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 99133 GA Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

4791 S Main St Ste 100
Acworth, GA 30101-5324

Mailing address

4791 S Main St Ste 100
Acworth, GA 30101-5324
Phone (404) 251-1600

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
I20241216002839 GA Practitioner - Family Practice 4587066014 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Physiotherapy Associates IncGroup PAC ID 3577470442, shared by 50 NPIs, 1,432 clinicians
Emory Specialty Associates, LLCGroup PAC ID 3476559782, 706 clinicians

Practice addresses (Care Compare)

110 Cherokee PL
Cartersville, GA 30121-2954
Phone (770) 386-6300

1364 Clifton Rd NE
Atlanta, GA 30322-1059
Phone (404) 778-3900

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94.51 of 100Reported as apm
Quality
80.61
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
99133GAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Emory Specialty Associates, LLC Family Medicine CurrentSince Aug 27, 2024 Accepting new patients
Emory Medical Group, LLC PastSince Jun 30, 2024 Accepting new patients

Locations

4791 S Main St
Ste 100
Acworth, GA 30101
Phone (404) 251-1600

4791 S Main St
Acworth, GA 30101
Phone (770) 422-1400

1364 Clifton Rd NE
Atlanta, GA 30322
Phone (404) 712-7100

2201 Henderson Mill Rd NE
Ste 160
Atlanta, GA 30345
Phone (404) 251-2193

1821 Clifton Rd NE
Atlanta, GA 30329
Phone (404) 728-6812

4500 N Shallowford Rd
Ste B
Dunwoody, GA 30338
Phone (404) 727-8843

1075 Big Shanty Rd NW
Kennesaw, GA 30144

Interoperability endpoints

  • Direct secure messaging: sfareed92985@direct.emory.org

Organizations & group practices 2

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": "1618272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719360000000",
    "number": "1861072746",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4791 S MAIN ST STE 100",
            "city": "ACWORTH",
            "state": "GA",
            "postal_code": "301015324",
            "telephone_number": "404-251-1600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4791 S MAIN ST STE 100",
            "city": "ACWORTH",
            "state": "GA",
            "postal_code": "301015324",
            "telephone_number": "404-251-1600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAREED",
        "first_name": "SHAAZ",
        "middle_name": "SYED",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-04-13",
        "last_updated": "2024-06-26",
        "certification_date": "2024-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "99133",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Acworth, GA

Sources for this page

Verify at the official NPI Registry.