Shailender K. Peesapati, M.D.

Primary specialty

Legal MedicineTaxonomy code 173000000X

License

055540 Issued in GA

Practice address

601 Old Norcross Rd
Ste a
Lawrenceville, GA 30046-4311

Phone

(770) 963-2474

Fax

(770) 963-2476

NPI assigned

Sep 2, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 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

Specialty

Internal MedicineAlso: Emergency Medicine

Education

Other, 1991

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

The Southeast Permanente Medical GroupGroup PAC ID 6204829013, 823 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• The Southeast Permanente Medical Group

  • Internal Medicine Physician
  • Atlanta, GA
  • NPI 1245266956
  Medicare reassignment Care Compare group NPD
• 24 On Physicians, PC

  • Hospitalist Physician
  • Rome, GA
  • NPI 1912956251
  Medicare reassignment NPD
• North Atlanta Professional Services LLC

  • Psychologist
  • Atlanta, GA
  • NPI 1316959869
  Medicare reassignment NPD
• 24 On Physicians, P.C.

  • Hospitalist Physician
  • Attleboro, MA
  • NPI 1790104511
  NPD
• Ecc Hospitalist Services PC

  • Hospitalist Physician
  • Rome, GA
  • NPI 1710108170
  NPD (past)

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

{
    "created_epoch": "1157155200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642032000000",
    "number": "1093817801",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 OLD NORCROSS RD",
            "address_2": "STE A",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300464311",
            "telephone_number": "770-963-2474",
            "fax_number": "770-963-2476"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 OLD NORCROSS RD",
            "address_2": "STE A",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300464311",
            "telephone_number": "770-963-2474",
            "fax_number": "770-963-2476"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEESAPATI",
        "first_name": "SHAILENDER",
        "middle_name": "K.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-02",
        "last_updated": "2022-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "173000000X",
            "taxonomy_group": "",
            "desc": "Legal Medicine",
            "state": "GA",
            "license": "055540",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepiceast.kp.org:14430/Interconnect-prodgam/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "1435 Broadmoor Blvd",
            "city": "Buford",
            "state": "GA",
            "country_code": "US",
            "postal_code": "305185408",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Pediatric Neurology and Epilepsy Center
• Julie Pefanis
• Peggy J. Mayfield PHD Abap PC
• Clayton Pelham Jr.
• Cassandra Pelissier
• Susan Allison Pellettieri

• Legal Medicine in Lawrenceville, GA
• Providers in Lawrenceville, GA by specialty
• Legal Medicine in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2022; 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.