Farzana B Mumtaz, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

036419 Issued in GA

Practice address

2404 Macy Dr
Roswell, GA 30076-6343

Phone

(770) 640-8814

Fax

(770) 640-8815

NPI assigned

Nov 5, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 5

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: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Family Practice

Education

Other, 1976

Medicare assignment

May accept Medicare assignment

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Hospital & facility affiliations

• Wellstar North Fulton Medical Center Hospital, Roswell, GA, CCN 110198
• Ross Memorial Health Care Ctr Nursing home, Kennesaw, GA, CCN 115515

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: farzana.mumtaz.1@12175.direct.athenahealth.com
• FHIR API: https://api.platform.athenahealth.com/12175/brand/1/csg/1/fhir/r4

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.

• Mumtaz Mumtaz Inc

  • Family Medicine Physician
  • Roswell, GA
  • NPI 1982783304
  Medicare reassignment NPD Authorized official

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Shady Grove Rest Home Inc

  • Skilled Nursing Facility
  • Kennesaw, GA
  • NPI 1538228648

  Nursing home

  Care Compare affiliation
• Wellstar North Fulton Hospital, Inc

  • General Acute Care Hospital
  • Roswell, GA
  • NPI 1750312997
  Care Compare affiliation

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

{
    "created_epoch": "1162684800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1861571291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2404 MACY DR",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "300766343",
            "telephone_number": "770-640-8814",
            "fax_number": "770-640-8815"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2404 MACY DR",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "300766343",
            "telephone_number": "770-640-8814",
            "fax_number": "770-640-8815"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUMTAZ",
        "first_name": "FARZANA",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "036419",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIGROUP HEALTH PLAN",
            "identifier": "000557576B",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000557576B",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLCARE HEALTH PLAN",
            "identifier": "319176",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAIL ROAD MEDICARE",
            "identifier": "P00245232",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PEACH STATE HEALTH PLAN",
            "identifier": "000557576B",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Olivia Mullen, OTD, OTR/L
• Heather Mulling
• Melissa Marie Mulvaney, MAE, DIPLAC, LAC
• Ishaq Sayyid Mumin
• Mumtaz Mumtaz Inc
• Sara Munroe
• Molly Ann Muntifering, APC
• Sarah Murdock
• Robert Brickell Murfree, DDS
• Michael Patrick Muro, MD

• Family Medicine Physician in Roswell, GA
• Providers in Roswell, GA by specialty
• Family Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.