NORTHEAST GEORGIA PODIATRY LLC – Foot & Ankle Surgery Podiatrist, NPI 1225575855

NORTHEAST GEORGIA PODIATRY LLC is a healthcare provider. based in Buford, Georgia. specializing in Foot & Ankle Surgery Podiatrist. The organization holds a License No. POD001208 (GA). The NPI Number for NORTHEAST GEORGIA PODIATRY LLC is 1225575855

Main info

Organization
Name
NORTHEAST GEORGIA PODIATRY LLC
NPI
1225575855
Phone
(470) 202-8004
Address
600 Garnett St Ste 7
Authorized Official
PURVI SHAAN SHAH PODIATRIST DPM
Enumeration Date
20 January 2017
Last Update Date
12 December 2025
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience42
Completeness85
Years active:9State licenses:1Digital endpointsOther names

Provider Addresses for NORTHEAST GEORGIA PODIATRY LLC

  • 600 Garnett St Ste 7

    Buford, GA 305183200

    Phone: (470) 202-8004

    Type: Location

  • 590 S ENOTA DR NE STE 1A

    GAINESVILLE, GA 305012433

    Phone: (470) 252-5756

    Type: Mailing

  • 4337 WALDEN WAY

    FLOWERY BRANCH, GA 305423090

    Phone: (813) 484-0152

    Type: Mailing

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: 2017-06-16

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Past revalidation due date

Earliest CMS due date was 2024-02-29 (830 days ago).

Enrollment records

1

Earliest due date

2024-02-29

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
O20170616001359OClinic/Group PracticeGA2024-02-29

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.

Verify on CMS Revalidation Lookup Tool

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 30518)

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Reviews

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Frequently asked questions

How do payers reference NORTHEAST GEORGIA PODIATRY LLC?
For NORTHEAST GEORGIA PODIATRY LLC, use NPI 1225575855 as the unique 10-digit identifier.
Would NORTHEAST GEORGIA PODIATRY LLC appear as active to a payer?
You can treat NORTHEAST GEORGIA PODIATRY LLC as active for directory purposes; confirm clinical privileges separately.
What area of care is associated with NORTHEAST GEORGIA PODIATRY LLC?
NORTHEAST GEORGIA PODIATRY LLC's record emphasizes Foot & Ankle Surgery Podiatrist. Clinical services aligned with this taxonomy classification.
What practice footprint exists for NORTHEAST GEORGIA PODIATRY LLC?
Travel planning: use Buford, Georgia as the reference point for NORTHEAST GEORGIA PODIATRY LLC, then confirm.
When was this NPI issued?
Enumeration for NORTHEAST GEORGIA PODIATRY LLC is noted as January 20, 2017 where the registry provides it.

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