NPIMap

Individual provider Active NPI

Morvarid Tavassoli, MD

  • Surgery Physician
  • Marietta, GA
National Provider Identifier
1861996811
Registry record updated Aug 31, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
101123 Issued in GA
Practice address
702 Canton Rd NE
Marietta, GA 30060-7271
Phone
(770) 428-4486
NPI assigned
Mar 22, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Oncology Physician 2086X0206X 101123 GA
Surgery Physician 208600000X 101123 GA Primary

Addresses

Primary practice location

702 Canton Rd NE
Marietta, GA 30060-7271

Mailing address

702 Canton Rd NE
Marietta, GA 30060-7271
Phone (770) 428-4486

Other practice location 1

4700 Waters Ave Ste 405
Savannah, GA 31404-6220
Phone (912) 350-2700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, SD2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20241115000491 GA Practitioner - General SurgeryPractitioner - Other (Physician) 8123552957 Reassigns benefits to 1 organization
I20260615003723 SD Practitioner - General Surgery 8123552957 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
University of California, Davis School of Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Philip Israel Breast Center PCGroup PAC ID 9931180098, 4 clinicians
Monument Health Rapid City Hospital IncGroup PAC ID 6002729506, 560 clinicians

Practice addresses (Care Compare)

1790 Mulkey Rd
Suite 9C
Austell, GA 30106-1122
Phone (770) 428-4486

353 Fairmont Blvd
Rapid City, SD 57701-7375
Phone (605) 755-8109

6002 Professional Pkwy
Suite 260
Douglasville, GA 30134-5628
Phone (770) 428-4486

702 Canton Rd
Marietta, GA 30060-7271

702 Canton Rd NE
Marietta, GA 30060-7271
Phone (770) 428-4486

Hospital & facility affiliations

  • Wellstar Kennestone Regional Medical Center Hospital, Marietta, GA, CCN 110035
  • Monument Health Rapid City Hospital Hospital, Rapid City, SD, CCN 430077
  • Wellstar Cobb Medical Center Hospital, Austell, GA, CCN 110143
  • Same Day Surgery Center LLC Hospital, Rapid City, SD, CCN 430093
  • Wellstar Douglas Medical Center Hospital, Douglasville, GA, CCN 110184

Procedures performed for Medicare patients

ProcedureNumber of procedures
Mastectomy18
Skin biopsy1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
The Philip Israel Breast Center, P.C. CurrentSince Oct 1, 2024 Accepting new patients
Kennestone Hospital, Inc PastSince Oct 27, 2024 Accepting new patients

Locations

702 Canton Rd NE
Marietta, GA 30060
Phone (770) 428-4486

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 and National Provider Directory roles.

Hospital & facility affiliations 16

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

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1521676800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788134400000",
    "number": "1861996811",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "702 CANTON RD NE",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300607271",
            "telephone_number": "770-428-4486"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "702 CANTON RD NE",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300607271",
            "telephone_number": "770-428-4486"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4700 Waters Ave Ste 405",
            "address_purpose": "LOCATION",
            "city": "Savannah",
            "state": "GA",
            "postal_code": "314046220",
            "country_code": "US",
            "telephone_number": "912-350-2700",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TAVASSOLI",
        "first_name": "MORVARID",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-22",
        "last_updated": "2026-08-31",
        "certification_date": "2026-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086X0206X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Oncology",
            "state": "GA",
            "license": "101123",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "GA",
            "license": "101123",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marietta, GA

Sources for this page

Verify at the official NPI Registry.