Individual provider Active NPI

Deepti A Munjal, MD

  • Hematology & Oncology Physician
  • Douglasville, GA
National Provider Identifier
1922086610
Registry record updated Aug 18, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
046627 Issued in GA
Practice address
4586 Timber Ridge Dr
Suite 200
Douglasville, GA 30135-7517
Phone
(770) 942-0457
Fax
(770) 942-7699
NPI assigned
Jan 4, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology Physician 207RH0003X 046627 GA Primary

Addresses

Primary practice location

4586 Timber Ridge Dr
Suite 200
Douglasville, GA 30135-7517

Mailing address

1835 Savoy Dr
Suite 300
Atlanta, GA 30341-1072
Phone (770) 942-0457

Other identifiers 2

IdentifierTypeStateIssuer
000810301AFMedicaidGA
000810301AEMedicaidGA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address deepti.munjalmd.p1@direct.gacancer.nextgenshare.com Direct

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
I20080226000408 GA Practitioner - Internal MedicinePractitioner - Hematology/Oncology 9133132962 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
NSH Cancer Institute Professional Services G LLCGroup PAC ID 0840443164, 115 clinicians

Practice addresses (Care Compare)

4586 Timber Ridge Dr
Suite 200
Douglasville, GA 30135-7514
Phone (770) 942-0457

Hospital & facility affiliations

  • Northside Hospital Hospital, Atlanta, GA, CCN 110161
  • Wellstar Cobb Medical Center Hospital, Austell, GA, CCN 110143
  • Wellstar Douglas Medical Center Hospital, Douglasville, GA, CCN 110184
  • Wellstar Paulding Medical Center Hospital, Hiram, GA, CCN 110042
  • Wellstar Kennestone Regional Medical Center Hospital, Marietta, GA, CCN 110035

Merit-based Incentive Payment System (MIPS)

Final score
71.19 of 100Reported as group
Quality
69.24
Improvement activities
40
Cost
51.37

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
NSH Cancer Institute Professional Services G LLC CurrentSince Jan 1, 2013 Accepting new patients
NSH Cancer Institute Professional Services G, LLC Hematology & Oncology CurrentSince Jan 1, 2013 Accepting new patients
Northside Imaging LLC Past Accepting new patients
Georgia Cancer Specialists I, PC Past Accepting new patients
NSH Cancer Institute Professional Services G, LLC Hematology & Oncology Past Accepting new patients

Locations

1835 Savoy Dr
Ste 300
Atlanta, GA 30341
Phone (678) 288-9555

1668 Mulkey Rd
Ste 164
Austell, GA 30106
Phone (770) 590-8311

4586 Timber Ridge Dr
Ste 200
Douglasville, GA 30135
Phone (770) 489-3513

6300 Hospital Pkwy
Ste 300
Johns Creek, GA 30097
Phone (770) 623-8965

1045 Southcrest Dr
Ste 200
Stockbridge, GA 30281
Phone (678) 289-0549

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 5

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": "1136332800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597708800000",
    "number": "1922086610",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1835 SAVOY DR",
            "address_2": "SUITE 300",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303411072",
            "telephone_number": "770-942-0457",
            "fax_number": "770-942-7699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4586 TIMBER RIDGE DR",
            "address_2": "SUITE 200",
            "city": "DOUGLASVILLE",
            "state": "GA",
            "postal_code": "301357517",
            "telephone_number": "770-942-0457",
            "fax_number": "770-942-7699"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUNJAL",
        "first_name": "DEEPTI",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-04",
        "last_updated": "2020-08-18",
        "certification_date": "2020-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "GA",
            "license": "046627",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000810301AF",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000810301AE",
            "state": "GA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "deepti.munjalmd.p1@direct.gacancer.nextgenshare.com",
            "affiliation": "N",
            "endpointDescription": "Direct Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Direct Edge",
            "address_1": "4586 Timber Ridge Dr",
            "address_2": "Suite 200",
            "city": "Douglasville",
            "state": "GA",
            "country_code": "US",
            "postal_code": "301357517",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Douglasville, GA

Sources for this page

Verify at the official NPI Registry.