Individual provider Active NPI

Fayyaz Barodawala, M.D.

  • Vascular & Interventional Radiology Physician
  • Macon, GA
National Provider Identifier
1942238084
Registry record updated Feb 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular & Interventional Radiology PhysicianTaxonomy code 2085R0204X
License
68755 Issued in GA
Practice address
770 Pine St Ste 290
Macon, GA 31201-7516
Phone
(478) 743-1458
NPI assigned
Jun 29, 2006
Last updated
Feb 16, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 16, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 68755 GA
Vascular & Interventional Radiology Physician 2085R0204X 68755 GA Primary

Addresses

Primary practice location

770 Pine St Ste 290
Macon, GA 31201-7516

Mailing address

770 Pine St Ste 290
Macon, GA 31201-7516
Phone (478) 743-1458

Other practice location 1

215 Sheraton Blvd Ste 2
Macon, GA 31210-1359
Phone (478) 757-8868

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
I20121126000225 GA Practitioner - Diagnostic Radiology 0345208872 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
State University of New York at Buffalo School of Medicine, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Central Georgia MRI LLCGroup PAC ID 5597752261, 46 clinicians
Georgia Magnetic Imaging Center LTDGroup PAC ID 0042205775, 39 clinicians
Radiology Associates of Macon PCGroup PAC ID 7113817701, 64 clinicians

Practice addresses (Care Compare)

770 Pine St
L15
Macon, GA 31201-7519
Phone (478) 746-1020

777 Hemlock St
Macon, GA 31201-2102
Phone (478) 633-1235

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Varicose vein removal16

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
68755GAMDVascular & Interventional Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Georgia Magnetic Imaging Center LTD Diagnostic Radiology CurrentSince Jan 1, 2020 Accepting new patients
Central Georgia MRI LLC Diagnostic Radiology CurrentSince Jan 1, 2020 Accepting new patients
Radiology Associates of Macon PC Diagnostic Radiology CurrentSince Jan 1, 2020 Accepting new patients
Buffalo Ultrasound, Idtf Inc CurrentSince Apr 15, 2022 Accepting new patients
Georgia Radiology Imaging Consultants, LLC Diagnostic Radiology CurrentSince Jun 29, 2020 Accepting new patients
Trustees of the University of Pennsylvania Past Accepting new patients
White Plains Radiology Associates PC Diagnostic Radiology Past Accepting new patients
Medical Center Radiologists Inc Diagnostic Radiology Past Accepting new patients
Univ of Penn Community Radiology Diagnostic Radiology Past Accepting new patients

Locations

2040 10th Ave
Columbus, GA 31901
Phone (706) 322-3000

710 Center St
Columbus, GA 31901
Phone (706) 571-1000

215 Sheraton Blvd
#2
Macon, GA 31210
Phone (478) 743-1458

770 Pine St
Ste 290
Macon, GA 31201
Phone (478) 743-1458

770 Pine St
Ste L15
Macon, GA 31201
Phone (478) 633-1819

777 Hemlock St
Macon, GA 31201
Phone (478) 474-5600

Interoperability endpoints

  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

Organizations & group practices 9

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 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": "1151539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708041600000",
    "number": "1942238084",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "770 PINE ST STE 290",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312017516",
            "telephone_number": "478-743-1458"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "770 PINE ST STE 290",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312017516",
            "telephone_number": "478-743-1458"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "215 Sheraton Blvd Ste 2",
            "address_purpose": "LOCATION",
            "city": "Macon",
            "state": "GA",
            "postal_code": "312101359",
            "country_code": "US",
            "telephone_number": "478-757-8868",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BARODAWALA",
        "first_name": "FAYYAZ",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-29",
        "last_updated": "2024-02-16",
        "certification_date": "2024-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "GA",
            "license": "68755",
            "primary": false
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "GA",
            "license": "68755",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Macon, GA

Sources for this page

Verify at the official NPI Registry.