Individual provider Active NPI

Ajay Kumar Ravi, M.D.

  • Vascular & Interventional Radiology Physician
  • Gainesville, GA
National Provider Identifier
1063533149
Registry record updated Dec 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular & Interventional Radiology PhysicianTaxonomy code 2085R0204X
License
69938 Issued in GA
Practice address
743 Spring St NE
Gainesville, GA 30501-3715
Phone
(770) 219-9000
NPI assigned
Apr 3, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X MD.203359 LA
Diagnostic Radiology Physician 2085R0202X 27363 OK
Vascular & Interventional Radiology Physician 2085R0204X 69938 GA Primary
Diagnostic Radiology Physician 2085R0202X 69938 GA

Addresses

Primary practice location

743 Spring St NE
Gainesville, GA 30501-3715

Mailing address

PO Box 742616
Atlanta, GA 30374-2616
Phone (770) 219-8420

Other practice location 1

200 W Academy Street
Gainesville, GA 30501
Phone (770) 282-8820

Other practice location 2

901 18th St E
Tifton, GA 31794-3648
Phone (229) 382-7120

Other practice location 3

350 Hospital Dr
Macon, GA 31217-3838
Phone (478) 765-7000

Other identifiers 1

IdentifierTypeStateIssuer
003135877ADMedicaidGA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address aravi31957@nghs.gadirect.net Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20130730000122 GA Practitioner - Diagnostic Radiology 3173792199 Reassigns benefits to 4 organizations
I20251118004386 GA Practitioner - Interventional Radiology 3173792199 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Piedmont Professional Services LLCGroup PAC ID 8921176231, 171 clinicians
Gainesville Radiology Group PCGroup PAC ID 9335046382, 65 clinicians
Northeast Georgia Physicians Group IncGroup PAC ID 6901898386, 884 clinicians

Practice addresses (Care Compare)

1267 Hwy 54 W 2200
Fayetteville, GA 30214-2110
Phone (470) 271-3415

1400 River PL
Braselton, GA 30517-5600
Phone (770) 219-9000

227 Mountain Dr
Dahlonega, GA 30533-1606
Phone (770) 219-9000

316 N Broad St
Winder, GA 30680-2150
Phone (770) 282-8820

3425 Buford Dr
Suite 100
Buford, GA 30519-8785
Phone (770) 282-8820

743 Spring Nest
Gainesville, GA 30501-3715
Phone (770) 219-6000

743 Spring St NE
Gainesville, GA 30501-3715
Phone (770) 535-3553

Hospital & facility affiliations

  • Northeast Georgia Medical Center, Inc Hospital, Gainesville, GA, CCN 110029
  • Coliseum Medical Centers, LLC, Dba Hospital, Macon, GA, CCN 110164
  • Piedmont Macon North Hospital Hospital, Macon, GA, CCN 110201
  • Piedmont Henry Hospital Hospital, Stockbridge, GA, CCN 110191
  • NGMC Barrow, LLC Hospital, Winder, GA, CCN 110045

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
69938GAMDDiagnostic Radiology Physician
MD.203359LAMDDiagnostic Radiology Physician
27363OKMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Piedmont Professional Services, LLC Family Medicine CurrentSince Dec 1, 2025 Accepting new patients
Gainesville Radiology Group, PC Diagnostic Radiology CurrentSince Nov 17, 2014 Accepting new patients
South Georgia Radiology Associates, LLC Diagnostic Radiology CurrentSince Jun 1, 2014 Accepting new patients
Northeast Georgia Physicians Group Inc Family Medicine CurrentSince Nov 6, 2025 Accepting new patients
Northeast Georgia Medical Center, Inc. Past Accepting new patients
Piedmont Medical Care Corporation Family Medicine Past Accepting new patients

Locations

163 E Tollison St
Baxley, GA 31513
Phone (912) 367-9847

1400 River Pl
Braselton, GA 30517
Phone (770) 219-6000

3425 Buford Dr
Ste 100
Buford, GA 30519
Phone (678) 765-6060

227 Mountain Dr
Dahlonega, GA 30533
Phone (706) 864-6136

108 Prominence Ct
Ste 120
Dawsonville, GA 30534
Phone (706) 344-6944

1267 Highway 54 W
Ste 2200
Fayetteville, GA 30214
Phone (470) 271-3415

725 Jesse Jewell Pkwy SE
Ste 360
Gainesville, GA 30501
Phone (770) 539-9391

3137 Frontage Rd
Gainesville, GA 30504
Phone (770) 219-0500

1250 Jesse Jewell Pkwy SE
Ste 500
Gainesville, GA 30501
Phone (770) 531-2444

535 Jesse Jewell Pkwy SE
Ste A
Gainesville, GA 30501
Phone (770) 534-9729

597 S Enota Dr NE
Gainesville, GA 30501
Phone (770) 219-8275

743 Spring St NE
Gainesville, GA 30501
Phone (770) 219-5915

200 W Academy St NW
Gainesville, GA 30501
Phone (770) 800-0041

350 Hospital Dr
Macon, GA 31217
Phone (478) 751-0367

2225 US Highway 41 N
Tifton, GA 31794
Phone (229) 353-3422

901 18th St E
Tifton, GA 31794
Phone (229) 353-6208

316 N Broad St
Winder, GA 30680
Phone (770) 307-5354

316 N Broad St
Ste 230
Winder, GA 30680

Organizations & group practices 8

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": "1175558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764547200000",
    "number": "1063533149",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 742616",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303742616",
            "telephone_number": "770-219-8420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "743 SPRING ST NE",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305013715",
            "telephone_number": "770-219-9000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "200 W Academy Street",
            "address_purpose": "LOCATION",
            "city": "Gainesville",
            "state": "GA",
            "postal_code": "30501",
            "country_code": "US",
            "telephone_number": "770-282-8820",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "901 18th St E",
            "address_purpose": "LOCATION",
            "city": "Tifton",
            "state": "GA",
            "postal_code": "317943648",
            "country_code": "US",
            "telephone_number": "229-382-7120",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "350 Hospital Dr",
            "address_purpose": "LOCATION",
            "city": "Macon",
            "state": "GA",
            "postal_code": "312173838",
            "country_code": "US",
            "telephone_number": "478-765-7000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RAVI",
        "first_name": "AJAY",
        "middle_name": "KUMAR",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-03",
        "last_updated": "2025-12-01",
        "certification_date": "2025-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "LA",
            "license": "MD.203359",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "OK",
            "license": "27363",
            "primary": false
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "GA",
            "license": "69938",
            "primary": true
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "GA",
            "license": "69938",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003135877AD",
            "state": "GA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "aravi31957@nghs.gadirect.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "743 Spring St NE",
            "city": "Gainesville",
            "state": "GA",
            "country_code": "US",
            "postal_code": "305013715",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Gainesville, GA

Sources for this page

Verify at the official NPI Registry.