Gautam Jagoo, MD

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

05601 Issued in GA

Practice address

1700 Medical Way
Snellville, GA 30078-2195

Phone

(770) 979-0200

NPI assigned

Feb 16, 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

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

Diagnostic RadiologyAlso: Interventional Radiology

Education

Tufts University School of Medicine, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

South Gwinnett Radiology PCGroup PAC ID 5496710493, 8 clinicians

Piedmont Professional Services LLCGroup PAC ID 8921176231, 171 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Piedmont Eastside Medical Center Hospital, Snellville, GA, CCN 110192
• Northside Hospital Hospital, Atlanta, GA, CCN 110161
• Piedmont Hospital, Inc Hospital, Atlanta, GA, CCN 110083
• Northside Hospital Gwinnett Hospital, Lawrenceville, GA, CCN 110087
• Emory University Hospital Hospital, Atlanta, GA, CCN 110010

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as group

Quality

100

Improvement activities

40

Cost

93.77

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as group

Quality

100

Improvement activities

40

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.

• South Gwinnett Radiology PC

  • Diagnostic Radiology Physician
  • Snellville, GA
  • NPI 1740232677
  Medicare reassignment Care Compare group NPD
• Piedmont Professional Services, LLC

  • Nephrology Physician
  • Stockbridge, GA
  • NPI 1104088905
  Medicare reassignment Care Compare group
• Preferred Vascular Services Macon LLC

  • Vascular Surgery Physician
  • Macon, GA
  • NPI 1437659455
  Medicare reassignment NPD
• Preferred Vascular Services Northeast

  • Vascular Surgery Physician
  • Atlanta, GA
  • NPI 1780184218
  Medicare reassignment NPD
• Preferred Vascular Services Northwest, LLC

  • Vascular Surgery Physician
  • Marietta, GA
  • NPI 1598037822
  Medicare reassignment NPD
• Preferred Vascular Services Southeast LLC

  • Vascular Surgery Physician
  • Lithonia, GA
  • NPI 1861992976
  Medicare reassignment NPD
• Preferred Vascular Services Southwest

  • Vascular Surgery Physician
  • Atlanta, GA
  • NPI 1790285229
  Medicare reassignment NPD
• Macon Vascular Care, LLC

  • Ambulatory Surgical Clinic/Center
  • Macon, GA
  • NPI 1841711942
  Medicare reassignment
• Radiology Associates of Dekalb PC

  • Diagnostic Radiology Physician
  • Decatur, GA
  • NPI 1245206119
  NPD (past)

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

• Eastside Medical Center, LLC

  • General Acute Care Hospital
  • Snellville, GA
  • NPI 1467406132
  Care Compare affiliation
• Emory University

  • General Acute Care Hospital
  • Atlanta, GA
  • NPI 1588640692
  Care Compare affiliation
• Emory University

  • General Acute Care Hospital
  • Atlanta, GA
  • NPI 1770560294
  Care Compare affiliation
• Northside Hospital, Inc.

  • General Acute Care Hospital
  • Atlanta, GA
  • NPI 1457396079
  Care Compare affiliation
• Northside Hospital, Inc.

  • General Acute Care Hospital
  • Lawrenceville, GA
  • NPI 1952340994
  Care Compare affiliation
• Piedmont Hospital, Inc

  • General Acute Care Hospital
  • Atlanta, GA
  • NPI 1962461681
  Care Compare affiliation

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

{
    "created_epoch": "1140048000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1124092986",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2225 SUNDOWN DR NE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303453552",
            "telephone_number": "404-805-4947",
            "fax_number": "404-501-5707"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 MEDICAL WAY",
            "city": "SNELLVILLE",
            "state": "GA",
            "postal_code": "300782195",
            "telephone_number": "770-979-0200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAGOO",
        "first_name": "GAUTAM",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "GA",
            "license": "05601",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Staci Lynn Jackson, OTR/L
• Theresa F Jackson
• Toni Marie Jackson, DO
• Jacquelyn Macey PA-C LLC
• Jae Pak PC
• Domonque Louise Jakes, RN
• Omar S Jalil, M.D.
• Jambah Group, LLC
• Andy James, CRNA
• Beverly James, O.T.

• Diagnostic Radiology Physician in Snellville, GA
• Providers in Snellville, GA by specialty
• Diagnostic Radiology Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.