NPIMap

Individual provider Active NPI

Pradeep C Jolly, MD

  • Hematology & Oncology Physician
  • Atlanta, GA
National Provider Identifier
1023096823
Registry record updated Apr 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
022798 Issued in GA
Practice address
1100 Johnson Fy Rd NE Ste 600
Atlanta, GA 30342-1739
Phone
(404) 256-4777
Fax
(404) 256-5515
NPI assigned
Jan 3, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology Physician 207RH0003X 022798 GA Primary

Addresses

Primary practice location

1100 Johnson Fy Rd NE Ste 600
Atlanta, GA 30342-1739

Mailing address

1835 Savoy Dr
Suite 300
Atlanta, GA 30341-1072
Phone (404) 256-4777

Other identifiers 2

IdentifierTypeStateIssuer
000294115AAMedicaidGA
000294115ABMedicaidGA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address pradeep.jollymd.p1@direct.gacancer.nextgenshare.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050816000727 GA Practitioner - Hematology/Oncology 8820995616 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Hematology/Oncology
Education
Other, 1975
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
NSH Cancer Institute Professional Services G LLCGroup PAC ID 0840443164, 115 clinicians

Practice addresses (Care Compare)

1100 Johnson Ferry Rd
Suite 600
Sandy Springs, GA 30342-1739
Phone (404) 256-4777

Hospital & facility affiliations

  • Northside Hospital Hospital, Atlanta, GA, CCN 110161
  • Northside Hospital Forsyth Hospital, Cumming, GA, CCN 110005
  • Northside Hospital Cherokee Hospital, Canton, GA, CCN 110008
  • Northside Hospital Gwinnett Hospital, Lawrenceville, GA, CCN 110087
  • Saint Joseph'S Hospital of Atlanta, Inc Hospital, Atlanta, GA, CCN 110082

Merit-based Incentive Payment System (MIPS)

Final score
71.19 of 100Reported as group
Quality
69.24
Improvement activities
40
Cost
51.37

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
022798GAMDHematology & Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
NSH Cancer Institute Professional Services G, LLC Hematology & Oncology Current Accepting new patients
NSH Cancer Institute Professional Services G LLC CurrentSince Jan 1, 2013 Accepting new patients
NSH Cancer Institute Professional Services G, LLC Hematology & Oncology CurrentSince Jan 1, 2013 Accepting new patients
Northside Imaging LLC Past Accepting new patients
Northside Hospital, Inc. PastSince May 4, 2009 Accepting new patients
Georgia Cancer Specialists I, PC Past Accepting new patients

Locations

3330 Preston Ridge Rd
Ste 110
Alpharetta, GA 30005
Phone (678) 566-6995

1835 Savoy Dr
Ste 300
Atlanta, GA 30341
Phone (678) 288-9555

620 J L White Dr
Ste 140
Jasper, GA 30143
Phone (706) 253-3500

6300 Hospital Pkwy
Ste 300
Johns Creek, GA 30097
Phone (770) 623-8965

1100 Johnson Fy Rd NE
Ste 600
Sandy Springs, GA 30342
Phone (404) 256-4777

1045 Southcrest Dr
Ste 200
Stockbridge, GA 30281
Phone (678) 289-0549

Interoperability endpoints

  • Direct secure messaging: pradeep.jollymd.p1@direct.gacancer.nextgenshare.com

Organizations & group practices 6

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.

Hospital & facility affiliations 5

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

NPI Registry JSON

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

{
    "created_epoch": "1136246400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618963200000",
    "number": "1023096823",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1835 SAVOY DR",
            "address_2": "SUITE 300",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303411072",
            "telephone_number": "404-256-4777",
            "fax_number": "404-256-5515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 JOHNSON FY RD NE STE 600",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303421739",
            "telephone_number": "404-256-4777",
            "fax_number": "404-256-5515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOLLY",
        "first_name": "PRADEEP",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-03",
        "last_updated": "2021-04-21",
        "certification_date": "2021-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "GA",
            "license": "022798",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000294115AA",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000294115AB",
            "state": "GA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "pradeep.jollymd.p1@direct.gacancer.nextgenshare.com",
            "affiliation": "N",
            "endpointDescription": "Direct Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Direct Edge",
            "address_1": "1100 Johnson Fy Rd NE Ste 600",
            "city": "Atlanta",
            "state": "GA",
            "country_code": "US",
            "postal_code": "303421739",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.