Individual provider Active NPI

Shayan Ahmadi, PAAA

  • Anesthesiologist Assistant
  • Atlanta, GA
National Provider Identifier
1902181738
Registry record updated Dec 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiologist AssistantTaxonomy code 367H00000X
License
006229 Issued in GA
Practice address
1000 Johnson Ferry Rd NE
Atlanta, GA 30342-1606
Phone
(770) 645-9181
NPI assigned
Oct 12, 2011
Last updated
Dec 15, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiologist Assistant 367H00000X ANT.0000317 CO
Anesthesiologist Assistant 367H00000X 006229 GA Primary

Addresses

Primary practice location

1000 Johnson Ferry Rd NE
Atlanta, GA 30342-1606

Mailing address

3155 N Point Pkwy Ste F100
Alpharetta, GA 30005-5495
Phone (770) 645-9181

Other practice location 1

1010 Three Springs Blvd
Durango, CO 81301-8296
Phone (970) 761-3200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120405000177 GA Practitioner - Anesthesiology Assistant 3870766983 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology Assistant
Education
Other, 2011
Medicare assignment
May accept Medicare assignment
Group practices
Mak Anesthesia Holdings, LLCGroup PAC ID 4284917204, 370 clinicians
Wellstar Medical Group LLCGroup PAC ID 6709065402, 3,059 clinicians

Practice addresses (Care Compare)

3950 Austell Rd
Austell, GA 30106-1121
Phone (770) 702-1806

5150 Stilesboro N W Rd
Suite 120
Kennesaw, GA 30152
Phone (678) 354-0230

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
Associate of Arts

State licenses

LicenseStateTypeSpecialty
043799GAMDCritical Care Medicine (Internal Medicine) Physician
ANT.0000317COMDAnesthesiologist Assistant
006229GAMDAnesthesiologist Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Wellstar Medical Group, LLC CurrentSince Feb 1, 2018 Accepting new patients
Catholic Health Initiatives Colorado CurrentSince Dec 9, 2025 Accepting new patients
Wellstar Medical Group, LLC Current Accepting new patients
Wellstar Medical Group, LLC CurrentSince Feb 1, 2018 Accepting new patients
Catholic Health Initiatives Colorado CurrentSince Dec 9, 2025 Accepting new patients

Locations

1010 Three Springs Blvd
Durango, CO 81301
Phone (970) 247-4311

41 State Highway 67
Woodland Park, CO 80863
Phone (719) 686-0551

3950 Austell Rd
Austell, GA 30106
Phone (770) 732-3752

5150 Stilesboro Rd NW
Ste 120
Kennesaw, GA 30152
Phone (678) 354-0230

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

3000 Hospital Blvd
Roswell, GA 30076
Phone (770) 751-2500

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1318377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765756800000",
    "number": "1902181738",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3155 N POINT PKWY STE F100",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "300055495",
            "telephone_number": "770-645-9181"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 JOHNSON FERRY RD NE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303421606",
            "telephone_number": "770-645-9181"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1010 Three Springs Blvd",
            "address_purpose": "LOCATION",
            "city": "Durango",
            "state": "CO",
            "postal_code": "813018296",
            "country_code": "US",
            "telephone_number": "970-761-3200",
            "fax_number": "970-764-3209",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AHMADI",
        "first_name": "SHAYAN",
        "credential": "PAAA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-10-12",
        "last_updated": "2025-12-15",
        "certification_date": "2025-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367H00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiologist Assistant",
            "state": "CO",
            "license": "ANT.0000317",
            "primary": false
        },
        {
            "code": "367H00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiologist Assistant",
            "state": "GA",
            "license": "006229",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.