1. Home
  2. Directory
  3. Georgia
  4. Cumming
  5. Family Medicine
  6. NPI Profile

SHEBA NAQVI MD
NPI 1093001018
Family Medicine in Cumming, GA

Active since June 28, 2011PECOS EnrolledAccepts Medicare Assignment
1230 BALD RIDGE MARINA RD STE 400, CUMMING, GA 30041(470) 826-1905(470) 826-3334 Get Directions Write a Review

NPPES record last updated: February 9, 2024. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Feb 9, 2024, Oct 2, 2019 (2 updates tracked since 2019).

About Sheba Naqvi Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SHEBA NAQVI MD (NPI 1093001018) is an individual family medicine provider in Cumming, Georgia, licensed in Georgia (68922) and active in the NPI registry since June 2011. She is enrolled in Medicare PECOS, is affiliated with Northside Hospital Forsyth, and is a graduate of Other (2002).

NPPES Registry Identity

NPI1093001018
Entity TypeIndividualFemale
Primary Taxonomy207Q00000X
Provider Legal NameSHEBA NAQVICredential: MD
Location Address1230 BALD RIDGE MARINA RD STE 400Cumming, GA 30041-7859
Mailing Address1230 Bald Ridge Marina Rd Ste 400Cumming, GA 30041-7859
Phone(470) 826-1905
Fax(470) 826-3334
Sole ProprietorNo
Medical School CMSOtherGraduated 2002
Enumeration DateJune 28, 2011
Last NPPES UpdateFebruary 9, 20242 updates tracked since enumeration
NPPES CertifiedFebruary 9, 2024
✔ NPI 1093001018 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in GA · 68922
Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

1230 BALD RIDGE MARINA RD STE 400, Cumming, GA 30041
Open in Google Maps ↗

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Absolute Total Care, Ambetter Health, Ambetter of Alabama and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Sheba Naqvi Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID2163666280
PECOS Enrollment IDI20130911000473
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 4

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
26 services14 patients
Insertion of needle into vein for collection of blood sample 36415
This procedure involves inserting a small needle into a vein, typically in your arm, to collect a blood sample. It's a quick and simple process to help diagnose or monitor health conditions. You may feel a small prick, but discomfort is minimal.
19 services13 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
19 services13 patients
New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204
This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.
14 services14 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Northside Hospital Forsyth

Acute Care Hospitals · Cumming, GA
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number110005
Location1200 Northside Forsyth DriveCumming, GA 30041 · Forsyth County
Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 30041 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$88.06 typical visit price
range $56.84 – $172.43
Typical copayment $22.01 (range $14.21 – $43.10)
Most-billed visit code 99203
Established Patient
$100.20 typical visit price
range $18.22 – $140.40
Typical copayment $25.05 (range $4.55 – $35.10)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

Reported Quality Measures

Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan
Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the previous twelve months AND with a BMI outside of normal parameters, a follow-up plan is documented during the encounter or during the previous…
100%210 patients5/55-star benchmark: 100%
Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Referred Medical Equipment & Supplies CMS DME claims 4

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg J7613
DME-Drugs Administered Through DME · category DG006N
2 suppliers19 claims4,471 services$0.03 avg. paid by Medicare
Ipratropium bromide, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, per milligram J7644
DME-Drugs Administered Through DME · category DG006N
1 supplier15 claims450 services$0.16 avg. paid by Medicare
Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service K0553
DME-Other DME · category DE017N
2 suppliers14 claims15 services$215.32 avg. paid by Medicare
Pharmacy dispensing fee for inhalation drug(s); per 30 days Q0513
DME-Other DME · category DE000N
3 suppliers18 claims18 services$24.58 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

BALD RIDGE FAMILY PRACTICE LLC
Family Medicine
1230 BALD RIDGE MARINA RD STE 400
CUMMING, GA 30041
Forsyth County (470) 826-1905

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Sheba Naqvi's NPI number?

The NPI number for Sheba Naqvi is 1093001018. It was assigned to this individual provider in the NPPES registry on June 28, 2011.

Where is Sheba Naqvi located?

Sheba Naqvi practices at 1230 Bald Ridge Marina Rd Ste 400, Cumming, GA 30041. The listed phone number is (470) 826-1905.

What is Sheba Naqvi's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Sheba Naqvi enrolled in Medicare?

Yes. Sheba Naqvi is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Sheba Naqvi accept?

Health plans from Ambetter Health, Ambetter from Absolute Total Care, Ambetter of Alabama, Ambetter of North Carolina and Ambetter of Tennessee list Sheba Naqvi as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Sheba Naqvi affiliated with any hospitals?

According to CMS data, Sheba Naqvi is affiliated with Northside Hospital Forsyth.

When was this NPI record last updated?

The NPPES record for Sheba Naqvi was last updated on February 9, 2024. NPI Profile syncs with the weekly NPPES data releases published by CMS.