NPIMap

Individual provider Active NPI

Mukul Vasant Patharkar, M.D.

  • Infectious Disease Physician
  • Fayetteville, GA
National Provider Identifier
1922157338
Registry record updated Apr 17, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
License
73781 Issued in GA
Practice address
1265 Highway 54 W
Suite 500-C
Fayetteville, GA 30214-4548
Phone
(678) 435-3040
Fax
(678) 435-3044
NPI assigned
Jan 9, 2007
Last updated
Apr 17, 2017By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Infectious Disease Physician 207RI0200X 73781 GA Primary
Infectious Disease Physician 207RI0200X 073781 GA

Addresses

Primary practice location

1265 Highway 54 W
Suite 500-C
Fayetteville, GA 30214-4548

Mailing address

77 12TH St NE
Apt 2012
Atlanta, GA 30309-3972
Phone (347) 247-9526

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151006000953 GA Practitioner - Infectious DiseasePractitioner - Internal Medicine 7012078413 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Infectious DiseaseAlso: Internal Medicine
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Atlanta Id Group PCGroup PAC ID 9638120231, 16 clinicians

Practice addresses (Care Compare)

1265 Hwy 54
Suite 500C
Fayetteville, GA 30214-4537
Phone (678) 435-3040

275 Collier Rd NW
Suite 450
Atlanta, GA 30309-1748
Phone (404) 351-8873

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
91.62 of 100Reported as apm
Quality
83.25
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
073781GAMDInfectious Disease Physician
73781GAMDInfectious Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Atlanta I.D. Group, PC Infectious Disease CurrentSince Jul 9, 2015 Accepting new patients

Locations

275 Collier Rd NW
Ste 450
Atlanta, GA 30309
Phone (404) 351-8873

1265 Highway 54 W
Ste 500C
Fayetteville, GA 30214
Phone (678) 435-3040

1365 Rock Quarry Rd
Ste 302
Stockbridge, GA 30281
Phone (770) 692-5830

Organizations & group practices 2

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.

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": "1168300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1492387200000",
    "number": "1922157338",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "77 12TH ST NE",
            "address_2": "APT 2012",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303093972",
            "telephone_number": "347-247-9526"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1265 HIGHWAY 54 W",
            "address_2": "SUITE 500-C",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302144548",
            "telephone_number": "678-435-3040",
            "fax_number": "678-435-3044"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATHARKAR",
        "first_name": "MUKUL",
        "middle_name": "VASANT",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-09",
        "last_updated": "2017-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "GA",
            "license": "73781",
            "primary": true
        },
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "GA",
            "license": "073781",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, GA

Sources for this page

Verify at the official NPI Registry.