Vivek V. Gurudutt, MD

Primary specialty

Otolaryngology PhysicianTaxonomy code 207Y00000X

License

73912 Issued in GA

Practice address

1360 Upper Hembree Rd
Suite 201B
Roswell, GA 30076-1171

Phone

(770) 475-3361

Fax

(770) 664-4431

NPI assigned

Jul 21, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: vivek.gurudutt.p137@direct.tenet.nextgenshare.com
• Direct secure messaging: vgurudutt123331@directwellstar.org

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.

• North Atlanta Ear Nose & Throat PC

  • Otolaryngology Physician
  • Cumming, GA
  • NPI 1871970210

  Otolaryngology

  NPD
• Icahn School of Medicine at Mount Sinai

  • Specialty Pharmacy
  • New York, NY
  • NPI 1629410816
  NPD (past)

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

{
    "created_epoch": "1153440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617667200000",
    "number": "1093736613",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4150 DEPUTY BILL CANTRELL MEMORIAL DR SUITE 260",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "300402721",
            "telephone_number": "770-292-3045",
            "fax_number": "770-292-3046"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1360 UPPER HEMBREE RD",
            "address_2": "SUITE 201B",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "300761171",
            "telephone_number": "770-475-3361",
            "fax_number": "770-664-4431"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GURUDUTT",
        "first_name": "VIVEK",
        "middle_name": "V.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-21",
        "last_updated": "2021-04-06",
        "certification_date": "2021-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "GA",
            "license": "73912",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "246039YEXC",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kristen Elise Gue, PA-C
• Jose Guevara, D.C.
• Guided Motion, LLC
• Sara Rae Guinn, M.M.ED, MT-BC
• Margaret G Gunter, LPC, NCC
• Pamela Van Gutwein, PAC
• Jennifer Leonor Guzman Garcia, M.D.
• Gwinnett Spinal & Rehab. Center, P.C.
• H&B Medical Services, P.a.
• Katharine Haase, OT

• Otolaryngology Physician in Roswell, GA
• Providers in Roswell, GA by specialty
• Otolaryngology Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2021; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.