Gordon Jerome Azar Jr. (NPI# 1144210642, PAC ID# 3173691557) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is INTERVENTIONAL CARDIOLOGY.
| Nation Provider ID (NPI) | 1144210642 |
| PAC ID by PECOS | 3173691557 |
| Professional Enrollment ID | I20081013000335 |
| Full Name | Gordon Jerome Azar Jr. |
| Organization Legal Name | NORTHSIDE CARDIOVASCULAR PROFESSIONAL SERVICES,LLC |
| Address |
Northside Heart 460 Northside Cherokee Blvd. Suite 190 Canton GA 30115 |
| Phone Number | 7709245095 |
| Gender | M |
| Medical School | EMORY UNIVERSITY SCHOOL OF MEDICINE |
| Graduation Year | 1987 |
| Primary Specialty | INTERVENTIONAL CARDIOLOGY |
| Secondary Specialties | CARDIOVASCULAR DISEASE (CARDIOLOGY), INTERNAL MEDICINE |
| Group Practice PAC ID | 9739189838 |
| Number of Group Practice Members | 44 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 110008 | NORTHSIDE HOSPITAL CHEROKEE |
| 110161 | NORTHSIDE HOSPITAL |
| 110005 | NORTHSIDE HOSPITAL FORSYTH |
| Address | Phone | Organization |
|---|---|---|
| Northside Heart, 460 Northside Cherokee Blvd. Suite 190, Canton, GA 30115 | 7709245095 | NORTHSIDE CARDIOVASCULAR PROFESSIONAL SERVICES,LLC |
| Measure Identifier | Measure Title | Performance Rate | Reporting Mechanism |
|---|---|---|---|
| ACI_EC_TRANS_PPHI_1 | Security Risk Analysis | % |
| Organization Legal Name | NORTHSIDE CARDIOVASCULAR PROFESSIONAL SERVICES,LLC |
| Physicians | 43 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Max M Benson | Interventional Cardiology | Northside Cardiovascular Professional Services,llc | 1505 Northside Forsyth Dr, Suite 3600, Cumming, GA 30041 |
| Stacy Ann Cartmell | Nurse Practitioner | Northside Cardiovascular Professional Services,llc | Northside Heart, 460 Northside Cherokee Blvd. Suite 190, Canton, GA 30115 |
| Rebecca Radke | Nurse Practitioner | Northside Cardiovascular Professional Services,llc | 993 Johnson Ferry Rd, Suite C120, Atlanta, GA 30342-4748 |
| Mary E Bergh | Cardiovascular Disease (cardiology) | Northside Cardiovascular Professional Services,llc | 1285 Upper Hembree Rd, Roswell, GA 30076-1143 |
| Niraj Sharma | Cardiovascular Disease (cardiology) | Northside Cardiovascular Professional Services,llc | 3000 Hospital Blvd, Roswell, GA 30076-4915 |
| Faresa Z Weragoda | Cardiovascular Disease (cardiology) | Northside Cardiovascular Professional Services,llc | 4800 Olde Towne Pkwy, Suite 420, Marietta, GA 30068-4424 |
| Yirima Simon | Physician Assistant | Northside Cardiovascular Professional Services,llc | 1285 Upper Hembree Rd, Roswell, GA 30076-1143 |
| Lois A Fairfield | Nurse Practitioner | Northside Cardiovascular Professional Services,llc | 3000 Hospital Blvd, Roswell, GA 30076-4915 |
| Aashish Desai | Interventional Cardiology | Northside Cardiovascular Professional Services,llc | Northside Heart, 460 Northside Cherokee Blvd. Suite 190, Canton, GA 30115 |
| Carolyn M Moore | Nurse Practitioner | Northside Cardiovascular Professional Services,llc | 1285 Upper Hembree Rd, Roswell, GA 30076-1143 |
| Street Address |
NORTHSIDE HEART 460 NORTHSIDE CHEROKEE BLVD. SUITE 190 |
| City | CANTON |
| State | GA |
| Zip | 30115 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Stacy Ann Cartmell | Nurse Practitioner | Northside Cardiovascular Professional Services,llc | Northside Heart, 460 Northside Cherokee Blvd. Suite 190, Canton, GA 30115 |
| Aashish Desai | Interventional Cardiology | Northside Cardiovascular Professional Services,llc | Northside Heart, 460 Northside Cherokee Blvd. Suite 190, Canton, GA 30115 |
| Ramal M Weragoda | Cardiac Electrophysiology | Northside Cardiovascular Professional Services,llc | Northside Heart, 460 Northside Cherokee Blvd. Suite 190, Canton, GA 30115 |
| Hyo Jin Song | Cardiovascular Disease (cardiology) | Northside Cardiovascular Professional Services,llc | Northside Heart, 460 Northside Cherokee Blvd. Suite 190, Canton, GA 30115 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Bingchan Zhang | Radiation Oncology | North Atlanta Professional Services LLC | 460 Northside Cherokee, Suite T10, Canton, GA 30115 |
| Vanessa Aquino-dick | Physical Therapy | Embrace Mobility Therapy Services | 402 Argonne Ter, Suite 220, Holly Springs, GA 30115-1880 |
| Valerie P Ciesla | Physical Therapy | Embrace Mobility Therapy Services | 402 Argonne Ter, Suite 220, Holly Springs, GA 30115-1880 |
| Ana A Mccook | Physical Therapy | Embrace Mobility Therapy Services | 402 Argonne Ter, Suite 220, Holly Springs, GA 30115-1880 |
| Ashley Burin | Physical Therapy | Pt Solutions of Acworth LLC | 1810 Cumming Hwy, Canton, GA 30115-2306 |
| John R Jackson | Emergency Medicine | 7768 Cumming Hwy 300, Canton, GA 30115-2982 | |
| Stephanie M Wordes | Physician Assistant | Resurgens, PC | 1495 Hickory Flat Hwy, Suite 200, Canton, GA 30115-4229 |
| Michele T Perez | Physical Medicine and Rehabilitation | Resurgens, PC | 1495 Hickory Flat Hwy, Suite 200, Canton, GA 30115-4229 |
| Trevor J Wallace | Physician Assistant | Resurgens, PC | 1495 Hickory Flat Hwy, Suite 200, Canton, GA 30115-4229 |
| Ryan Chen | Orthopedic Surgery | Resurgens, PC | 1495 Hickory Flat Hwy, Suite 200, Canton, GA 30115-4229 |
| Find all physicians in zip 30115 | |||
| City | CANTON |
| Zip Code | 30115 |
| Specialty | INTERVENTIONAL CARDIOLOGY |
| City + Specialty | CANTON + INTERVENTIONAL CARDIOLOGY |
Please comment or provide details below to improve the information on Gordon Jerome Azar Jr..
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.