DR. OMAR MUSHFIQ MD, MPH
NPI 1225068034
Internal Medicine - Nephrology in Gainesville, GA

Q: What is Omar Mushfiq's NPI number?

The NPI number for Omar Mushfiq is 1225068034. It was assigned to this individual provider in the NPPES registry on July 4, 2006.

Q: What is Omar Mushfiq's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Nephrology, with taxonomy code 207RN0300X.

Q: When was this NPI record last updated?

The NPPES record for Omar Mushfiq was last updated on December 18, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since July 04, 2006PECOS EnrolledAccepts Medicare Assignment

743 SPRING ST NE, GAINESVILLE, GA 30501(770) 219-2627(770) 219-7365 Get Directions Write a Review

NPPES record last updated: December 18, 2015. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Dec 18, 2015, Dec 11, 2015 (2 updates tracked since 2015).

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About Dr. Omar Mushfiq Md, Mph NPPES

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

DR. OMAR MUSHFIQ MD, MPH (NPI 1225068034) is an individual nephrology provider in Gainesville, Georgia, licensed in Georgia (057399) and active in the NPI registry since July 2006. He is enrolled in Medicare PECOS, is affiliated with St Mary's Hospital, and is a graduate of Other (1985).

NPPES Registry Identity

NPI1225068034

Entity TypeIndividualMale

Primary Taxonomy207RN0300X

Provider Legal NameDR. OMAR MUSHFIQCredential: MD, MPH

Location Address743 SPRING ST NEGainesville, GA 30501-3715

Mailing AddressPo Box 742616Atlanta, GA 30374-2616 · (770) 219-8420 · Fax (770) 219-8440

Phone(770) 219-2627

Fax(770) 219-7365

Sole ProprietorNo

Medical School CMSOtherGraduated 1985

Enumeration DateJuly 4, 2006

Last NPPES UpdateDecember 18, 20152 updates tracked since enumeration

✔ NPI 1225068034 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal Medicine · NephrologyAllopathic & Osteopathic Physicians

Taxonomy Code207RN0300X

License✔ Licensed in GA · 057399

Definition

An internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation.

Also ListedInternal MedicineTaxonomy 207R00000X · License 057399 (GA)

743 SPRING ST NE, Gainesville, GA 30501

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Other Identifiers 2

Medicare UPINH86857GA

Medicare OSCAR/certification39BDCNCGA

Accepted Insurance

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

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Omar Mushfiq Md, Mph 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 ID244291482

PECOS Enrollment IDI20060905000440

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.

Medicare Billing Reassignments

Medicare enrollment records show Omar Mushfiq reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Kidneyclinic Of Athens

33 mi

Health Service

385 HAWTHORNE LN STE 200
Athens, GA 30606

Reassigned Medicare billing, Georgia enrollment
4 clinicians in this Medicare group

NPI 1174742621 (706) 543-3130

Hospital Physician Services - Southeast Professional Corporation

35 mi

Hospitalist

2151 W SPRING ST
Monroe, GA 30655

Reassigned Medicare billing, Georgia enrollment
777 clinicians in this Medicare group

NPI 1760410385 (770) 267-8461

Apogee Medical Group Georgia Inc

88 mi

Internal Medicine

705 DIXIE ST
Carrollton, GA 30117

Reassigned Medicare billing, Georgia enrollment
335 clinicians in this Medicare group

NPI 1629025143 (770) 836-9667

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 11

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.

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes 99233

Follow-up hospital inpatient care per day typically involves a 35-minute check-up by your healthcare provider. This service includes monitoring your health progress, adjusting your treatment plan if needed, and answering any questions you may have about your condition or care.

383 services80 patients

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.

249 services102 patients

Dialysis services, 4 or more physician visits per month (20 years or older) 90960

Dialysis is a treatment that filters and purifies your blood using a machine. It helps keep your fluids and electrolytes in balance when the kidneys can't do their job. This service includes 4 or more visits per month with a physician to monitor your health and adjust your treatment as needed.

163 services59 patients

Management using the results of remote vital sign monitoring per calendar month, first 20 minutes 99457

This service involves reviewing and managing your health data, which is remotely monitored and collected. Your vital signs like heart rate and blood pressure are tracked regularly throughout the month. The first 20 minutes of this data analysis per month is included in this service.

128 services21 patients

Dialysis services, 2-3 physician visits per month (20 years or older) 90961

Dialysis is a treatment that performs the function of healthy kidneys if they're not working properly. It removes waste and excess fluid from your blood. 2-3 physician visits per month are recommended for monitoring your health and adjusting your treatment as needed. This service is available for those aged 20 years and older.

73 services48 patients

Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes 99223

Initial hospital inpatient care per day, typically 70 minutes, refers to the daily medical service provided to patients admitted to the hospital. This includes a comprehensive evaluation, diagnosis, treatment plan, and monitoring of your health condition. It ensures your well-being during your hospital stay.

51 services37 patients

Remote monitoring of physiologic parameters, initial supply of devices with daily recordings or programmed alerts transmission, each 30 days 99454

This service involves using devices to remotely track body functions like heart rate or blood pressure. These devices, provided initially, record data daily or send alerts if readings are abnormal. The service is renewed every 30 days.

30 services14 patients

Physician or allowed practitioner certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and G0180

This is a service where a doctor or authorized practitioner certifies that you require Medicare-covered home health services. They will communicate with the home health agency and review reports on your health status to ensure you receive appropriate care. This does not involve an in-person visit.

29 services21 patients

Hemodialysis procedure with physician evaluation 90935

Hemodialysis is a treatment that uses a machine to filter waste and excess fluid from your blood when your kidneys can't. A physician checks your health before, during, and after the procedure to ensure it's working effectively for you.

21 services14 patients

New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203

This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.

20 services20 patients

Complete ultrasound scan behind abdominal cavity 76770

A complete ultrasound scan behind the abdominal cavity is a non-invasive imaging procedure. It uses sound waves to create pictures of the structures and organs located at the back of your abdomen. It helps in diagnosing health conditions and monitoring ongoing treatments.

15 services15 patients

Hospital Affiliations CMS Care Compare 4

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

St Mary's Hospital

Acute Care Hospitals · Athens, GA

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number110006

Location1230 Baxter StreetAthens, GA 30606 · Clarke County

Emergency services Birthing friendly

Ty Cobb Regional Medical Center, LLC

Acute Care Hospitals · Lavonia, GA

2/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number110027

Location367 Clear Creek ParkwayLavonia, GA 30553 · Franklin County

Emergency services Birthing friendly

Piedmont Walton Hospital

Acute Care Hospitals · Monroe, GA

4/5 CMS rating

OwnershipProprietary

CMS Certification Number110046

Location2151 W Spring StreetMonroe, GA 30655 · Walton County

Emergency services Birthing friendly

Piedmont Athens Regional Medical Center

Acute Care Hospitals · Athens, GA

4/5 CMS rating

OwnershipVoluntary non-profit - Other

CMS Certification Number110074

Location1199 Prince AvenueAthens, GA 30606 · Clarke County

Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 30501 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

$124.10 typical visit price

range $53.31 – $164.04

Typical copayment $31.02 (range $13.32 – $41.01)

Most-billed visit code 99204

Established Patient

$94.84 typical visit price

range $16.68 – $133.24

Typical copayment $23.71 (range $4.17 – $33.31)

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.

Other Providers at the Same Location NPPES 20

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

DARRYL E BLALOCK CRNA

Nurse Anesthetist, Certified Registered