EASTSIDE INTERNAL MEDICINE, LLC
NPI 1932256526
Legal Medicine in Conyers, GA

Q: What is Eastside Internal Medicine, LLC's NPI number?

The NPI number for Eastside Internal Medicine, LLC is 1932256526. It was assigned to this organization in the NPPES registry on January 4, 2007.

Q: What is Eastside Internal Medicine, LLC's specialty?

The primary specialty registered for this NPI is Legal Medicine with taxonomy code 173000000X.

Active since January 04, 2007

2080 EASTSIDE DR, SUITE A, CONYERS, GA 30013(678) 625-7800(678) 625-7888 Get Directions Write a Review

NPPES record last updated: July 21, 2022. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Jul 21, 2022, Aug 22, 2020 (2 updates tracked since 2020).

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About Eastside Internal Medicine, Llc NPPES

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

EASTSIDE INTERNAL MEDICINE, LLC (NPI 1932256526) is a healthcare organization registered as a legal medicine in Conyers, Georgia and active in the NPI registry since January 2007. The organization lists Henrietta Maddox, Office Manager, as its authorized official.

NPPES Registry Identity

NPI1932256526

Entity TypeOrganization

Primary Taxonomy173000000X

Legal Business NameEASTSIDE INTERNAL MEDICINE, LLC

Location Address2080 EASTSIDE DR, SUITE AConyers, GA 30013-1953

Mailing Address2080 Eastside Dr, Suite AConyers, GA 30013-1953 · (678) 625-7800 · Fax (678) 625-7888

Phone(678) 625-7800

Fax(678) 625-7888

Organization SubpartNo

Authorized OfficialHenrietta MaddoxOffice Manager · (678) 625-7800

Enumeration DateJanuary 4, 2007

Last NPPES UpdateJuly 21, 20222 updates tracked since enumeration

✔ NPI 1932256526 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyLegal MedicineOther Service Providers

Taxonomy Code173000000X

Definition

The specialty areas of medicine concerned with matters of, and relations with, substantive law and legal institutions; such as the conduct of medical examinations at crime scenes, performance of autopsies, giving of expert medical testimony in judicial proceedings, medical treatment of inmates of penal institutions, the practice of trauma medicine in law enforcement settings, and other clinical practice and medical science applications in the fields of law, law enforcement, and corrections.

2080 EASTSIDE DR, Conyers, GA 30013

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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Eastside Internal Medicine, Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 3 clinicians reassign Medicare billing to Eastside Internal Medicine, LLC, which bills Medicare for the services they deliver. Of these, 3 practice at this address. They are listed nearest first.

Clinicians, nearest first (3)

Farhana Quasem, MD

Internal Medicine

NPI 1093773905

2080 EASTSIDE DRIVE SUITE A
Conyers, GA 30013

(678) 625-7800

✔ PECOS✔ Accepts MedicareSame address

Masood Siddiquee, MD

Internal Medicine

NPI 1871551788

2080 EASTSIDE DRIVE SUITE A
Conyers, GA 30013

(678) 625-7800

✔ PECOS✔ Accepts MedicareSame address

Syed Wasim, MD

Internal Medicine

NPI 1992763809

2080 EASTSIDE DRIVE SUITE A
Conyers, GA 30013

(678) 625-7800

✔ PECOS✔ Accepts MedicareSame address

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

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 Eastside Internal Medicine, LLC's NPI number?

The NPI number for Eastside Internal Medicine, LLC is 1932256526. It was assigned to this organization in the NPPES registry on January 4, 2007.

Where is Eastside Internal Medicine, LLC located?

Eastside Internal Medicine, LLC is located at 2080 Eastside Dr Suite A, Conyers, GA 30013. The listed phone number is (678) 625-7800.

What is Eastside Internal Medicine, LLC's specialty?

The primary specialty registered for this NPI is Legal Medicine with taxonomy code 173000000X.

Is Eastside Internal Medicine, LLC enrolled in Medicare?

Yes. Eastside Internal Medicine, LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Eastside Internal Medicine, LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 3 clinicians, all in Internal Medicine, reassign their Medicare billing to Eastside Internal Medicine, LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Of these, 3 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Eastside Internal Medicine, LLC was last updated on July 21, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.