Individual provider Active NPI

Sameer Patel

  • Family Medicine Physician
  • Macon, GA
National Provider Identifier
1861713992
Registry record updated Nov 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
067307 Issued in GA
Practice address
3400 Riverside Dr
Macon, GA 31210-2513
Phone
(478) 474-5600
Fax
(478) 471-6769
NPI assigned
Jun 11, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 16, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 067307 GA Primary

Addresses

Primary practice location

3400 Riverside Dr
Macon, GA 31210-2513

Mailing address

3495 Piedmont Rd NE
Attn: Tobie Shelley
Atlanta, GA 30305-1717
Phone (404) 365-0966

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130710000100 GA Practitioner - Family Practice 4385891167 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northeast Georgia Physicians Group Urgent Care LLCGroup PAC ID 3274535687, 62 clinicians

Practice addresses (Care Compare)

852 Dacula Rd
Dacula, GA 30019-3185
Phone (770) 848-9381

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
88.16 of 100Reported as group
Quality
85.71
Promoting interoperability
100
Improvement activities
40
Cost
74.81

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of nail tissue1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Northeast Georgia Physicians Group Urgent Care LLC Family Medicine CurrentSince Nov 21, 2022 Accepting new patients
The Southeast Permanente Medical Group Family Medicine CurrentSince Nov 13, 2018 Accepting new patients

Locations

3495 Piedmont Rd NE
Bldg 9
Atlanta, GA 30305
Phone (404) 364-7000

1515 River Pl
Ste 100
Braselton, GA 30517
Phone (770) 848-6195

852 Dacula Rd
Dacula, GA 30019
Phone (770) 848-9360

2400 Mount Zion Pkwy
Jonesboro, GA 30236
Phone (770) 603-3649

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 1

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": "1276214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1542326400000",
    "number": "1861713992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3495 PIEDMONT RD NE",
            "address_2": "ATTN: TOBIE SHELLEY",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303051717",
            "telephone_number": "404-365-0966"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 RIVERSIDE DR",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312102513",
            "telephone_number": "478-474-5600",
            "fax_number": "478-471-6769"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "SAMEER",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-06-11",
        "last_updated": "2018-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "067307",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Macon, GA

Sources for this page

Verify at the official NPI Registry.