Amena M Imtiaz, MD

Primary specialty

Neurology PhysicianTaxonomy code 2084N0400X

License

064832 Issued in GA

Practice address

20 Glenlake Parkway
Kaiser Permanente Glenlake Medical Center
Atlanta, GA 30328

Phone

(205) 934-5038

NPI assigned

May 3, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Amena M Hasan Former name

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in GA, VA, TN, MO4 enrollments

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 4

Specialty

Neurology

Education

Medical College of Georgia School of Medicine, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Freeman-Oak Hill Health SystemGroup PAC ID 8325942253, shared by 14 NPIs, 385 clinicians

Wellmont Medical Associates IncGroup PAC ID 8123291739, shared by 2 NPIs, 432 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Freeman Health System - Freeman West Hospital, Joplin, MO, CCN 260137

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Freeman-Oak Hill Health System

  • Multi-Specialty Clinic/Center
  • Joplin, MO
  • NPI 1679517023

  Neurology

  Medicare reassignment NPD
• Freeman-Oak Hill Health System

  • General Acute Care Hospital
  • Joplin, MO
  • NPI 1891809679
  Medicare reassignment NPD
• Wellmont Medical Associates Inc

  • Family Medicine Physician
  • Big Stone Gap, VA
  • NPI 1174808216
  Medicare reassignment NPD
• Wellmont Medical Associates Inc

  • Pulmonary Disease Physician
  • Kingsport, TN
  • NPI 1780986257
  Medicare reassignment NPD
• The Southeast Permanente Medical Group

  • Internal Medicine Physician
  • Atlanta, GA
  • NPI 1245266956
  Medicare reassignment
• Wellmont Medical Associates, Inc.

  • Psychiatry Physician
  • Johnson City, TN
  • NPI 1275393522
  NPD
• Wellmont Medical Associates, Inc.

  • Urgent Care Clinic/Center
  • Bristol, VA
  • NPI 1295193183
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Freeman-Oak Hill Health System

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Webb City, MO
  • NPI 1114394228

  Hospital

  Care Compare affiliation
• Freeman-Oak Hill Health System

  • General Acute Care Hospital
  • Joplin, MO
  • NPI 1265546048
  Care Compare affiliation

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

{
    "created_epoch": "1178150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757635200000",
    "number": "1932321361",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3495 PIEDMONT RD NE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303051717",
            "telephone_number": "205-587-9269"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 GLENLAKE PARKWAY",
            "address_2": "KAISER PERMANENTE GLENLAKE MEDICAL CENTER",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "30328",
            "telephone_number": "205-934-5038"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1102 W 32nd St",
            "address_purpose": "LOCATION",
            "city": "Joplin",
            "state": "MO",
            "postal_code": "648043503",
            "country_code": "US",
            "telephone_number": "417-347-4570",
            "fax_number": "417-347-6755",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "IMTIAZ",
        "first_name": "AMENA",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-03",
        "last_updated": "2025-09-12",
        "certification_date": "2025-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "GA",
            "license": "064832",
            "primary": true
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "MO",
            "license": "2025031058",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepiceast.kp.org:14430/Interconnect-prodgam/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "3650 Steve Reynolds Blvd",
            "city": "Duluth",
            "state": "GA",
            "country_code": "US",
            "postal_code": "300964506",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "AMENA",
            "last_name": "HASAN",
            "middle_name": "M",
            "credential": "M.D",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Imperfection Connection
• Imperishable Home Care LLC
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• Ims Healthcare Inc
• Ims Hospice
• In Excess LLC
• In Focus Eye Center, P.C.
• In Home Health LLC
• In Home Health, LLC
• In Tara Care Home Health Agency LLC

• Neurology Physician in Atlanta, GA
• Providers in Atlanta, GA by specialty
• Neurology Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.