Individual provider Active NPI

Saraswathi Jampala, MD

  • Internal Medicine Physician
  • Johns Creek, GA
National Provider Identifier
1083615710
Registry record updated Jul 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
049807 Issued in GA
Practice address
11912 Jones Bridge Rd
Johns Creek, GA 30005-4613
Phone
(678) 990-1831
Fax
(678) 990-1835
NPI assigned
Aug 3, 2005
Last updated
Jul 10, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X T6123 TX
Internal Medicine Physician 207R00000X 049807 GA Primary
General Practice Physician 208D00000X 049807 GA

Addresses

Primary practice location

11912 Jones Bridge Rd
Johns Creek, GA 30005-4613

Mailing address

11511 Shadow Creek Pkwy
Pearland, TX 77584-7298
Phone (713) 442-0000

Other practice location 1

3625 E League City Pkwy
League City, TX 77573-4509
Phone (713) 442-2826

Other identifiers 3

IdentifierTypeStateIssuer
270046459FMedicaidGA
270046459GMedicaidGA
58-1762046OtherGAGEORGIA CLINIC, PC /GROUP TAX ID

Other names 1

  • Saraswathi Tummala Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, TX2 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
I20040106000062 GA Practitioner - Internal Medicine 9830098268 Reassigns benefits to 1 organization
I20230125001519 TX Practitioner - Internal Medicine 9830098268 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1111 W Adoue St
Alvin, TX 77511-2718
Phone 28182414801594

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
T6123TXMDInternal Medicine Physician
049807GAMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kelsey-Seybold Medical Group, PLLC Internal Medicine CurrentSince Aug 14, 2023 Accepting new patients
Northside Primary Care Professional Services, LLC General Practice CurrentSince Dec 1, 2012 Accepting new patients
Boston Heart Diagnostics Corporation CurrentSince Jun 24, 2017 Accepting new patients
Northside Primary Care Professional Services,LLC Current Accepting new patients
Morehouse Healthcare, Inc. Internal Medicine PastSince Jul 1, 2012 Accepting new patients
Pasadena Health Center, Inc Past Accepting new patients

Locations

407 E Maple St
Ste 101
Cumming, GA 30040
Phone (770) 888-6697

3350 Paddocks Pkwy
Suwanee, GA 30024
Phone (678) 474-9633

3350 Paddocks Pkwy
#3350A
Suwanee, GA 30024
Phone (678) 474-9633

201 Enterprise Ave
Ste 900
League City, TX 77573
Phone (713) 442-2826

3625 E League City Pkwy
League City, TX 77573
Phone (713) 442-2826

11511 Shadow Creek Pkwy
Pearland, TX 77584
Phone (713) 442-4997

Organizations & group practices 7

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

NPI Registry JSON

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

{
    "created_epoch": "1123027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688947200000",
    "number": "1083615710",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11511 SHADOW CREEK PKWY",
            "city": "PEARLAND",
            "state": "TX",
            "postal_code": "775847298",
            "telephone_number": "713-442-0000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11912 JONES BRIDGE RD",
            "city": "JOHNS CREEK",
            "state": "GA",
            "postal_code": "300054613",
            "telephone_number": "678-990-1831",
            "fax_number": "678-990-1835"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3625 E League City Pkwy",
            "address_purpose": "LOCATION",
            "city": "League City",
            "state": "TX",
            "postal_code": "775734509",
            "country_code": "US",
            "telephone_number": "713-442-2826",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JAMPALA",
        "first_name": "SARASWATHI",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-03",
        "last_updated": "2023-07-10",
        "certification_date": "2023-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "T6123",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "049807",
            "primary": true
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "GA",
            "license": "049807",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "270046459F",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "270046459G",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GEORGIA CLINIC, PC /GROUP TAX ID",
            "identifier": "58-1762046",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SARASWATHI",
            "last_name": "TUMMALA",
            "credential": "MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Johns Creek, GA

Sources for this page

Verify at the official NPI Registry.