Individual provider Active NPI

Minar Mustafiz

  • Physician Assistant
  • Sandy Springs, GA
National Provider Identifier
1972226116
Registry record updated Jun 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
8095 Roswell Rd Ste a
Sandy Springs, GA 30350-3931
Phone
(770) 394-7868
NPI assigned
Sep 22, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

8095 Roswell Rd Ste a
Sandy Springs, GA 30350-3931

Mailing address

673 Coventry Township LN
Marietta, GA 30062-3227
Phone (213) 568-5639

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
I20250312002814 GA Practitioner - Physician Assistant 1658892179 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
12243GAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Etowah Emergency Physicians, LLC CurrentSince Jun 10, 2025 Accepting new patients

Locations

2360 Rockmart Hwy
Cedartown, GA 30125
Phone (770) 748-2500

Interoperability endpoints

  • Direct secure messaging: minar.mustafiz.1@20067.direct.athenahealth.com

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1663804800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749772800000",
    "number": "1972226116",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "673 COVENTRY TOWNSHIP LN",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300623227",
            "telephone_number": "213-568-5639"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8095 ROSWELL RD STE A",
            "city": "SANDY SPRINGS",
            "state": "GA",
            "postal_code": "303503931",
            "telephone_number": "770-394-7868"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUSTAFIZ",
        "first_name": "MINAR",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-09-22",
        "last_updated": "2025-06-13",
        "certification_date": "2025-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sandy Springs, GA

Sources for this page

Verify at the official NPI Registry.