Khaja Ahmed, M.D.
Individual provider Active NPI Family Medicine Physician · Dacula, GA
NPI 1902910409 · NPPES record last updated Oct 3, 2025
Key facts
- NPI
- 1902910409
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 42159 (GA)
- Practice address
- 852 Dacula Rd
Dacula, GA 30019-3185 - Phone
- (770) 848-9360
- Fax
- (770) 848-9361
- NPI assigned
- Aug 19, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 3
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- Other, 1987
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Northeast Georgia Physicians Group Inc
Practice addresses (Care Compare)
852 Dacula Rd
Dacula, GA 30019-3185
Phone (770) 848-9360
Hospital & facility affiliations
- Northeast Georgia Medical Center, Inc
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in GA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20040320000696 | GA | Practitioner - Family Practice | 0446141436 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Osteopathy, Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 42159 | GA | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Northeast Georgia Physicians Group Inc | Family Medicine | Current |
Accepting new patients |
| Dekalb County Board of Health | Past | Accepting new patients |
Locations
852 Dacula Rd
Dacula, GA 30019
Phone (770) 848-9360
597 S Enota Dr NE
Gainesville, GA 30501
Phone (770) 219-8275
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 42159 | GA | Yes |
Addresses
Primary practice location
852 Dacula Rd
Dacula, GA 30019-3185
Mailing address
PO Box 742616
Atlanta, GA 30374-2616
Phone (770) 219-8420
Other practice location 1
2732 Candler Rd
Decatur, GA 30034-1410
Phone (470) 444-3133
Other practice location 2
204 Dawson Village Way S
Dawsonville, GA 30534-5629
Phone (770) 268-4360
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000922127A | Medicaid | GA | |
| 080174767 | Other | MEDICARE RAILROAD |
Other providers in Dacula, GA
- Christabel Sarfo Adomako
- Advanced Foot and Ankle Centers of Georgia
- Affinity Angels Care Helens Adult Day Center
- Affinity Angels Home Care LLC
- Mary Agyei Mensah
- Samiha Ahsan
- Aid First Transportation, LLC
- Wislet Aime
- Vivian Chioma Akabueze
- Adenike Alaga
All providers in Dacula, GA · Family Medicine Physician in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 3, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.