Individual provider Active NPI

Pardeep Kumar Mittal, M.D

  • Diagnostic Radiology Physician
  • Atlanta, GA
National Provider Identifier
1871527770
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
049245 Issued in GA
Practice address
Emory University Hospital and Clinic
Dept. of Radiology - Suite , a 141
Atlanta, GA 30322-0001
Phone
(404) 712-1868
NPI assigned
Jul 10, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 049245 GA Primary

Addresses

Primary practice location

Emory University Hospital and Clinic
Dept. of Radiology - Suite , a 141
Atlanta, GA 30322-0001

Mailing address

1551 Reserve Cir
Decatur, GA 30033-1538
Phone (404) 325-3817

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
I20050216000021 GA Practitioner - Diagnostic Radiology 1254383417 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Other, 1979
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wellstar Medical Group LLCGroup PAC ID 6709065402, 3,059 clinicians

Practice addresses (Care Compare)

1120 15TH St
Augusta, GA 30912-0004
Phone (706) 721-8623

3722 Wheeler Rd
Augusta, GA 30909-6756

5150 Stilesboro N W Rd
Suite 220
Kennesaw, GA 30152-7742
Phone (770) 424-8222

6135 Roosevelt Hwy
Warm Springs, GA 31830-2757
Phone (706) 655-5461

989 Saint Sebastian Way
Augusta, GA 30912-0004
Phone (706) 721-2171

Hospital & facility affiliations

  • Wellstar MCG Health, Affiliated With Med Col Hospital, Augusta, GA, CCN 110034
  • Aiken Regional Medical Center Hospital, Aiken, SC, CCN 420082

Merit-based Incentive Payment System (MIPS)

Final score
93.93 of 100Reported as apm
Quality
82.14
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Au Health Imaging, LLC Diagnostic Radiology CurrentSince Aug 27, 2020 Accepting new patients
Au Medical Associates Inc CurrentSince Apr 16, 2018 Accepting new patients
Wellstar Medical Group, LLC CurrentSince Sep 1, 2023 Accepting new patients
Au Medical Associates Inc CurrentSince Apr 16, 2018 Accepting new patients
Wellstar Medical Group, LLC Current Accepting new patients

Locations

1120 15th St
Augusta, GA 30912
Phone (706) 721-3873

5150 Stilesboro Rd NW
Ste 220
Kennesaw, GA 30152
Phone (770) 424-8222

Organizations & group practices 5

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 4

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": "1152489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1871527770",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1551 RESERVE CIR",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300331538",
            "telephone_number": "404-325-3817"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "EMORY UNIVERSITY HOSPITAL AND CLINIC",
            "address_2": "DEPT. OF RADIOLOGY - SUITE , A 141",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303220001",
            "telephone_number": "404-712-1868"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITTAL",
        "first_name": "PARDEEP",
        "middle_name": "KUMAR",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "GA",
            "license": "049245",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.