Eileen Javellana, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

045841 Issued in GA

Practice address

725 Jesse Jewell Pkwy SE
Gainesville, GA 30501-3834

Phone

(678) 207-4373

Fax

(770) 533-4727

NPI assigned

Jan 18, 2006

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Other identifiers 28

Medicare fee-for-service enrollment

Enrolled in GA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Internal Medicine

Education

Wayne State University School of Medicine, 1995

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

The Longstreet Clinic, PCGroup PAC ID 2668465733, 140 clinicians

Northeast Georgia Community Physicians LLCGroup PAC ID 3274010582, 129 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Northeast Georgia Medical Center, Inc Hospital, Gainesville, GA, CCN 110029

Merit-based Incentive Payment System (MIPS)

Final score

89.1 of 100Reported as group

Quality

87.6

Promoting interoperability

100

Improvement activities

40

Cost

76.07

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: eileen.javellana@longstreetclinic.gadirect.net

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Northeast Georgia Community Physicians LLC

  • Internal Medicine Physician
  • Gainesville, GA
  • NPI 1881583730
  Medicare reassignment Care Compare group NPD
• The Longstreet Clinic, PC

  • Internal Medicine Physician
  • Gainesville, GA
  • NPI 1326019977
  Medicare reassignment Care Compare group NPD
• The Longstreet Clinic PC

  • Prosthetic/Orthotic Supplier
  • Gainesville, GA
  • NPI 1053422428
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Northeast Georgia Medical Center, Inc.

  • General Acute Care Hospital
  • Gainesville, GA
  • NPI 1427055821
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

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    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715040000000",
    "number": "1003896952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 658",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305030658",
            "telephone_number": "770-718-1122",
            "fax_number": "770-533-4786"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "725 JESSE JEWELL PKWY SE",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305013834",
            "telephone_number": "678-207-4373",
            "fax_number": "770-533-4727"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1120 Peachtree Industrial Blvd",
            "address_purpose": "LOCATION",
            "city": "Suwanee",
            "state": "GA",
            "postal_code": "300242013",
            "country_code": "US",
            "telephone_number": "678-207-4620",
            "fax_number": "678-207-4619",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JAVELLANA",
        "first_name": "EILEEN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-18",
        "last_updated": "2024-05-07",
        "certification_date": "2024-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "GA",
            "license": "045841",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "045841",
            "primary": true
        },
        {
            "code": "207RB0002X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Obesity Medicine",
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            "license": "045841",
            "primary": false
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    "identifiers": [
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            "code": "01",
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            "identifier": "582117020045",
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        {
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            "code": "01",
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            "issuer": "RR MEDICARE-GRP # CC4177",
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        {
            "code": "01",
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            "issuer": "CIGNA",
            "identifier": "2448449",
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            "code": "05",
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            "issuer": null,
            "identifier": "000800555M",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIGROUP",
            "identifier": "10045921",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRAILBLAZER HEALTH ENTERPRISES",
            "identifier": "110029C048846",
            "state": "GA"
        },
        {
            "code": "01",
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            "issuer": "MEDICARE CAHABA GBA",
            "identifier": "11BDRZS",
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            "identifier": "000800555B",
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            "code": "01",
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            "issuer": "TRICARE CERTIFIED",
            "identifier": "582117020057",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "0400503",
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        {
            "code": "05",
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            "issuer": null,
            "identifier": "000800555F",
            "state": "GA"
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        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000800555K",
            "state": "GA"
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            "code": "05",
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            "issuer": null,
            "identifier": "000800555N",
            "state": "GA"
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        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLCARE",
            "identifier": "340854",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PALMETTO RAILROAD MEDICARE PART B",
            "identifier": "110211686",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "52598478",
            "state": "GA"
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        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE CERTIFIED",
            "identifier": "582117020",
            "state": "GA"
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        {
            "code": "01",
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            "issuer": "ATENA",
            "identifier": "783517",
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            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COVENTRY HEALTHCARE",
            "identifier": "767999",
            "state": "GA"
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    "endpoints": [],
    "other_names": []
}

• Jannet Smith
• John C Jaques, P.A.
• Brandi Jarvis
• Virginia Diane Jarvis, DO
• Alfredo J Jaume, MD
• Jacob Jay, MD
• Sharani Umayangani Jayaratne, MD
• Vanita Jayswal, MD
• Derianne Jeff-Eke, MD, MPH
• Anjelica Jefferson, CPNP-AC

• Internal Medicine Physician in Gainesville, GA
• Providers in Gainesville, GA by specialty
• Internal Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.