Individual provider Active NPI

Rahul Kasan, PA-C

  • Physician Assistant
  • Atlanta, GA
National Provider Identifier
1922729821
Registry record updated Sep 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
11134 Issued in GA
Practice address
2061 Peachtree Rd NE Ste 200
Atlanta, GA 30309-1439
Phone
(404) 345-6056
NPI assigned
Sep 8, 2022
Last updated
Sep 8, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Interventional Pain Medicine Physician 208VP0014X 11134 GA
Physician Assistant 363A00000X 11134 GA Primary

Addresses

Primary practice location

2061 Peachtree Rd NE Ste 200
Atlanta, GA 30309-1439

Mailing address

3390 Peachtree Rd NE Ste 1500
Atlanta, GA 30326-2822

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220920001900 GA Practitioner - Physician Assistant 2668857160 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1388 Wellbrook Necir a
Conyers, GA 30012-3872
Phone (770) 929-9033

Merit-based Incentive Payment System (MIPS)

Final score
83.66 of 100Reported as group
Quality
74.46
Promoting interoperability
99
Improvement activities
40
Cost
71.9

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
The Interventional Spine and Pain Management Center PC Interventional Pain Medicine CurrentSince Sep 12, 2022 Accepting new patients
The Interventional Spine and Pain Management Center, PC Interventional Pain Medicine CurrentSince Sep 12, 2022 Accepting new patients
CPM Labs, LLC Current Accepting new patients

Locations

2061 Peachtree Rd NE
Ste 200
Atlanta, GA 30309
Phone (404) 345-6056

3390 Peachtree Rd NE
Ste 1500
Atlanta, GA 30326
Phone 40492049502501

1388 Wellbrook Cir NE
#A
Conyers, GA 30012
Phone (770) 385-7985

Organizations & group practices 3

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": "1662595200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662595200000",
    "number": "1922729821",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3390 PEACHTREE RD NE STE 1500",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303262822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2061 PEACHTREE RD NE STE 200",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303091439",
            "telephone_number": "404-345-6056"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KASAN",
        "first_name": "RAHUL",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-09-08",
        "last_updated": "2022-09-08",
        "certification_date": "2022-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "GA",
            "license": "11134",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "11134",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.