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DR. MOHAMMED KUMAIL ALI MD, MSC, MBA
NPI 1790130540
Family Medicine in Decatur, GA

Active since April 29, 2016PECOS EnrolledAccepts Medicare Assignment
92.26/100
CMS Quality Rating
158 W PONCE DE LEON AVE, DECATUR, GA 30030(404) 251-2200(404) 377-0814 Get Directions Write a Review

NPPES record last updated: August 28, 2019. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Aug 28, 2019, Jul 16, 2019, Sep 6, 2018 and 1 more (4 updates tracked since 2018).

About Dr. Mohammed Kumail Ali Md, Msc, Mba NPPES

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

DR. MOHAMMED KUMAIL ALI MD, MSC, MBA (NPI 1790130540) is an individual family medicine provider in Decatur, Georgia, licensed in Georgia (81987) and active in the NPI registry since April 2016. He is enrolled in Medicare PECOS, is affiliated with Emory University Hospital, and is a graduate of Other (2003).

NPPES Registry Identity

NPI1790130540
Entity TypeIndividualMale
Primary Taxonomy207Q00000X
Provider Legal NameDR. MOHAMMED KUMAIL ALICredential: MD, MSC, MBA
Location Address158 W PONCE DE LEON AVEDecatur, GA 30030-2527
Mailing Address158 W Ponce De Leon AveDecatur, GA 30030-2527 · (404) 251-2200 · Fax (404) 377-0814
Phone(404) 251-2200
Fax(404) 377-0814
Sole ProprietorNo
Medical School CMSOtherGraduated 2003
Enumeration DateApril 29, 2016
Last NPPES UpdateAugust 28, 20194 updates tracked since enumeration
✔ NPI 1790130540 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in GA · 81987
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.
Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X
158 W PONCE DE LEON AVE, Decatur, GA 30030
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

Dr. Mohammed Kumail Ali Md, Msc, Mba 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 ID4880987288
PECOS Enrollment IDI20190820003550
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 6

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.
43 services30 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.
37 services34 patients
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439
An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.
19 services19 patients
Pneumococcal conjugate vaccine, 20 valent (pcv20), for intramuscular use 90677
The Pneumococcal Conjugate Vaccine (PCV20) is a shot given to protect against 20 types of bacteria that can cause serious infections like pneumonia and meningitis. It's administered through a muscle, usually in the arm. It's important for overall health.
11 services11 patients
Administration of pneumococcal vaccine G0009
The pneumococcal vaccine helps protect against pneumococcal bacteria, which can cause severe infections like pneumonia and meningitis. The vaccine is given as an injection, typically in the arm. It's recommended for infants, older adults, and those with certain health conditions.
11 services11 patients
Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit G0438
An annual wellness visit is a yearly appointment with your doctor to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's an opportunity to discuss your health status and goals and get a plan tailored for you.
11 services11 patients

Hospital Affiliations CMS Care Compare 3

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

Emory University Hospital

Acute Care Hospitals · Atlanta, GA
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number110010
Location1364 Clifton Road, NEAtlanta, GA 30322 · De Kalb County
Emergency services

Emory Decatur Hospital

Acute Care Hospitals · Decatur, GA
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number110076
Location2701 N Decatur RoadDecatur, GA 30033 · De Kalb County
Emergency services Birthing friendly

Emory University Hospital Midtown

Acute Care Hospitals · Atlanta, GA
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number110078
Location550 Peachtree Street, NEAtlanta, GA 30308 · Fulton County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 30030 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.

92.26/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality73.83
Promoting Interoperability100
Improvement Activities40

Other Providers at the Same Location NPPES 2

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

KRISTINA L LUNDBERG MD
Internal Medicine
158 W PONCE DE LEON AVE
DECATUR, GA 30030
Dekalb County (404) 855-2229
MARY MICHAELS STOUT MD
Internal Medicine
158 W PONCE DE LEON AVE
DECATUR, GA 30030
Dekalb County (404) 251-2200

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 Mohammed Ali's NPI number?

The NPI number for Mohammed Ali is 1790130540. It was assigned to this individual provider in the NPPES registry on April 29, 2016.

Where is Mohammed Ali located?

Mohammed Ali practices at 158 W Ponce De Leon Ave, Decatur, GA 30030. The listed phone number is (404) 251-2200.

What is Mohammed Ali's specialty?

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

Is Mohammed Ali enrolled in Medicare?

Yes. Mohammed Ali 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 Mohammed Ali accept?

Health plans from Ambetter Health, Ambetter from Absolute Total Care, Ambetter of Alabama, Ambetter of North Carolina and Ambetter of Tennessee list Mohammed Ali 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 Mohammed Ali affiliated with any hospitals?

According to CMS data, Mohammed Ali is affiliated with Emory University Hospital, Emory Decatur Hospital and Emory University Hospital Midtown.

When was this NPI record last updated?

The NPPES record for Mohammed Ali was last updated on August 28, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.