Individual provider Active NPI

Nadine Becker, M.D.

  • Gynecology Physician
  • Atlanta, GA
National Provider Identifier
1962564021
Registry record updated Oct 15, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gynecology PhysicianTaxonomy code 207VG0400X
License
040311 Issued in GA
Practice address
960 Johnson Ferry Rd NE
Ste 400
Atlanta, GA 30342-4771
Phone
(404) 257-0170
Fax
(404) 591-3146
NPI assigned
Dec 15, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gynecology Physician 207VG0400X 040311 GA Primary

Addresses

Primary practice location

960 Johnson Ferry Rd NE
Ste 400
Atlanta, GA 30342-4771

Mailing address

960 Johnson Ferry Rd NE
Ste 400
Atlanta, GA 30342-4771
Phone (404) 257-0170

Other identifiers 4

IdentifierTypeStateIssuer
00677971AMedicaidGA
00677971HMedicaidGA
499239OtherGABCSB
5746121OtherGAAETNA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address pcw_atlanta@pcw.gwaydirect.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
I20120111000727 GA Practitioner - Obstetrics/Gynecology 7416124656 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Emory University School of Medicine, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northside Surgical Professional Services LLCGroup PAC ID 8628253424, 367 clinicians

Practice addresses (Care Compare)

960 Johnson Fy Rd NE
Suite 400
Atlanta, GA 30342-4771
Phone (404) 257-0170

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal or shaving of skin growth1-10
Removal of the uterus1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Northside Surgical Professional Services LLC CurrentSince Sep 1, 2015 Accepting new patients

Locations

980 Johnson Fy Rd NE
Ste 620
Sandy Springs, GA 30342
Phone (404) 252-9751

1000 Johnson Fy Rd NE
Sandy Springs, GA 30342
Phone (404) 851-1000

980 Johnson Fy Rd NE
Ste 220
Sandy Springs, GA 30342
Phone (404) 255-5956

960 Johnson Fy Rd NE
Ste 400
Sandy Springs, GA 30342
Phone (404) 257-0170

Organizations & group practices 1

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 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": "1166140800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602720000000",
    "number": "1962564021",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "960 JOHNSON FERRY RD NE",
            "address_2": "STE 400",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303424771",
            "telephone_number": "404-257-0170",
            "fax_number": "404-591-3146"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "960 JOHNSON FERRY RD NE",
            "address_2": "STE 400",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303424771",
            "telephone_number": "404-257-0170",
            "fax_number": "404-591-3146"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BECKER",
        "first_name": "NADINE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-15",
        "last_updated": "2020-10-15",
        "certification_date": "2020-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VG0400X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "GA",
            "license": "040311",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00677971A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00677971H",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCSB",
            "identifier": "499239",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "5746121",
            "state": "GA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "pcw_atlanta@pcw.gwaydirect.com",
            "affiliation": "N",
            "endpointDescription": "Direct Messaging",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Direct Edge",
            "address_1": "960 Johnson Ferry Rd NE",
            "address_2": "Ste 400",
            "city": "Atlanta",
            "state": "GA",
            "country_code": "US",
            "postal_code": "303424771",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.