INFECTIOUS DISEASE PROFESSIONALS, LLC – Infectious Disease Physician, NPI 1174613459
Infectious Disease Physician
Main info
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for INFECTIOUS DISEASE PROFESSIONALS, LLC
11379, Southbridge Parkway, Alpharetta, Fulton, Georgia, 30022, United States
UNIT C
ALPHARETTA, GA 300224469
Phone: (678) 517-5645
Fax: (770) 667-9038
Type: Mailing
4255 Johns Creek Pkwy Ste A
Suwanee, GA 300246122
Phone: (678) 845-7300
Type: Location
1400 NORTHSIDE FORSYTH DR STE 310
CUMMING, GA 300416017
Phone: (678) 845-7300
Type: Location
PO BOX 3988
ALPHARETTA, GA 300233988
Phone: (678) 542-3499
Fax: (678) 252-9679
Type: Mailing
101 GREENFIELD DR STE 100
CUMMING, GA 300402727
Phone: (678) 845-7300
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2004-06-11
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Past revalidation due date
Earliest CMS due date was 2024-02-29 (836 days ago).
Enrollment records
1
Earliest due date
2024-02-29
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| O20040611000896 | O | Clinic/Group Practice | GA | 2024-02-29 |
What to do next
- Verify current status on the CMS Revalidation Lookup Tool immediately.
- Complete revalidation in PECOS or contact your Medicare Administrative Contractor (MAC).
- Overdue revalidation can lead to deactivation of Medicare billing privileges.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 30022)
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