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GHULAM ILYAS M.D
NPI 1972966265
Pathology - Anatomic Pathology & Clinical Pathology in Johns Creek, GA

Active since April 04, 2016PECOS EnrolledAccepts Medicare Assignment
92.26/100
CMS Quality Rating
6325 HOSPITAL PKWY, JOHNS CREEK, GA 30097(516) 312-9848 Get Directions Write a Review

NPPES record last updated: June 27, 2021. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jun 27, 2021, May 18, 2021, May 24, 2020 and 1 more (4 updates tracked since 2016).

About Ghulam Ilyas M.d NPPES

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

GHULAM ILYAS M.D (NPI 1972966265) is an individual anatomic pathology & clinical pathology provider in Johns Creek, Georgia, licensed in Georgia (88046) and active in the NPI registry since April 2016. He is enrolled in Medicare PECOS, is affiliated with Emory University Hospital, and maintains 2 additional practice locations.

NPPES Registry Identity

NPI1972966265
Entity TypeIndividualMale
Primary Taxonomy207ZP0102X
Provider Legal NameGHULAM ILYASCredential: M.D
Location Address6325 HOSPITAL PKWYJohns Creek, GA 30097-5775
Mailing Address6325 Hospital PkwyJohns Creek, GA 30097-5775 · (678) 474-7000
Phone(516) 312-9848
Sole ProprietorNo
Medical School CMSOtherGraduated 2009
Enumeration DateApril 4, 2016
Last NPPES UpdateJune 27, 20214 updates tracked since enumeration
NPPES CertifiedJune 27, 2021
✔ NPI 1972966265 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPathology · Anatomic Pathology & Clinical PathologyAllopathic & Osteopathic Physicians
Taxonomy Code207ZP0102X
Licenses✔ Licensed in GA · 88046✔ Licensed in IL · 036151147
Definition
A pathologist deals with the causes and nature of disease and contributes to diagnosis, prognosis and treatment through knowledge gained by the laboratory application of the biologic, chemical and physical sciences. A pathologist uses information gathered from the microscopic examination of tissue specimens, cells and body fluids, and from clinical laboratory tests on body fluids and secretions for the diagnosis, exclusion and monitoring of disease.
Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X
6325 HOSPITAL PKWY, Johns Creek, GA 30097
Open in Google Maps ↗

Secondary Practice Locations 2

Location 1SUNY 450 Clarkson AvenueBrooklyn, NY 11203 · Phone (516) 312-9848
Location 25841 S Maryland Ave # Mc3083Chicago, IL 60637-1443 · Phone (773) 834-2555 · Fax (773) 702-1119

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arizona Complete Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections 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

Ghulam Ilyas M.d 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 ID2163843210
PECOS Enrollment IDI20210614002606, I20241011001190
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 13

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.

Pathology examination of tissue using a microscope, intermediate complexity 88305
A pathology examination of tissue with intermediate complexity involves studying a small sample of your body tissue under a microscope. This helps in identifying any abnormal cells or signs of disease. It's a detailed process requiring expert analysis to ensure accurate results.
835 services383 patients
Pathology examination of tissue using a microscope, intermediate complexity 88305
A pathology examination of tissue with intermediate complexity involves studying a small sample of your body tissue under a microscope. This helps in identifying any abnormal cells or signs of disease. It's a detailed process requiring expert analysis to ensure accurate results.
744 services351 patients
Special stained specimen slides to examine tissue, each additional procedure 88341
Special stained specimen slides are used to analyze tissue in detail. In this process, extra procedures may be needed for a more thorough examination. These involve applying special stains to the tissue on slides, enhancing specific elements for closer study.
270 services89 patients
Special stained specimen slides to examine tissue including interpretation and report 88313
Special stained specimen slides are used to examine tissue samples. This involves applying special dyes to the tissue, which helps to highlight certain features under a microscope. The findings are then interpreted and a report is provided. This can aid in diagnosing various health conditions.
252 services152 patients
Special stained specimen slides to identify organisms including interpretation and report 88312
This service involves coloring specimen slides in a special way to help identify organisms. The colors make different parts of the organism stand out. Afterward, a detailed interpretation and report on the findings are provided.
181 services129 patients
Special stained specimen slides to examine tissue, initial procedure 88342
This procedure involves the use of specially stained slides to examine tissue samples. The initial process involves obtaining a small tissue sample from your body. This sample is then placed on a slide and stained with special dyes to highlight different structures and elements. The stained slide is then examined under a microscope to help diagnose any potential health issues.
175 services130 patients

Hospital Affiliations CMS Care Compare 4

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 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

Northside Hospital

Acute Care Hospitals · Atlanta, GA
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number110161
Location1000 Johnson Ferry Road, NEAtlanta, GA 30342 · Fulton County
Birthing friendly

Emory Johns Creek Hospital

Acute Care Hospitals · Johns Creek, GA
3/5 CMS rating
OwnershipProprietary
CMS Certification Number110230
Location6325 Hospital ParkwayJohns Creek, GA 30097 · Gwinnett County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 30097 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
$130.64 typical visit price
range $56.84 – $172.43
Typical copayment $32.66 (range $14.21 – $43.10)
Most-billed visit code 99204
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 20

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

LESLEY DANIELLE SALVATIERRA CSFA
Specialist/Technologist, Other (Surgical Assistant)
6325 HOSPITAL PKWY
JOHNS CREEK, GA 30097
Gwinnett County (678) 474-7000
ELENA BELYKH MD
Hospitalist
6325 HOSPITAL PKWY
JOHNS CREEK, GA 30097
Gwinnett County (678) 474-7038
JEREMY WHITLEY M.D.
Emergency Medicine
6325 HOSPITAL PKWY
JOHNS CREEK, GA 30097
Gwinnett County (678) 474-7100
DR. JONATHON BLAKE HENDRIX CRNA
Anesthesiology (Critical Care Medicine)
6325 HOSPITAL PKWY
JOHNS CREEK, GA 30097
Gwinnett County (678) 474-7000
SUNG EUN LEE
Registered Nurse
6325 HOSPITAL PKWY
JOHNS CREEK, GA 30097
Gwinnett County (678) 520-7690
BRANDI WOOD M.D.
Obstetrics & Gynecology
6325 HOSPITAL PKWY
JOHNS CREEK, GA 30097
Gwinnett County (678) 474-7000
PAULA JEAN GUNTER MARTIN CRNA
Nurse Anesthetist, Certified Registered
6325 HOSPITAL PKWY, EMORY JOHNS CREEK HOSP
JOHNS CREEK, GA 30097
Gwinnett County (404) 778-8311
SRIVIDYA KODURU
Family Medicine
6325 HOSPITAL PKWY
JOHNS CREEK, GA 30097
Gwinnett County (678) 474-7038

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 Ghulam Ilyas's NPI number?

The NPI number for Ghulam Ilyas is 1972966265. It was assigned to this individual provider in the NPPES registry on April 4, 2016.

Where is Ghulam Ilyas located?

Ghulam Ilyas practices at 6325 Hospital Pkwy, Johns Creek, GA 30097. The listed phone number is (516) 312-9848.

What is Ghulam Ilyas's specialty?

The primary specialty registered for this NPI is Pathology, specializing in Anatomic Pathology & Clinical Pathology, with taxonomy code 207ZP0102X.

Is Ghulam Ilyas enrolled in Medicare?

Yes. Ghulam Ilyas 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 Ghulam Ilyas accept?

Health plans from Ambetter from Arizona Complete Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter from Superior HealthPlan and Ambetter of Oklahoma and 3 other insurers list Ghulam Ilyas 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 Ghulam Ilyas affiliated with any hospitals?

According to CMS data, Ghulam Ilyas is affiliated with Emory University Hospital, Emory University Hospital Midtown, Northside Hospital and Emory Johns Creek Hospital.

When was this NPI record last updated?

The NPPES record for Ghulam Ilyas was last updated on June 27, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.