Individual provider Active NPI

Adarsh Manjunath, MD

  • Urology Physician
  • Chicago, IL
National Provider Identifier
1144619933
Registry record updated Oct 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
89159 Issued in GA
Practice address
251 E Huron St
Chicago, IL 60611-2908
Phone
(312) 926-2000
NPI assigned
Jan 15, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X 036.145044 IL
Urology Physician 208800000X 89159 GA Primary

Addresses

Primary practice location

251 E Huron St
Chicago, IL 60611-2908

Mailing address

144 Bill Carruth Pkwy Ste 2300
Hiram, GA 30141-3821
Phone (770) 428-4475

Other practice location 1

144 Bill Carruth Pkwy Ste 2300
Hiram, GA 30141-3821
Phone (770) 428-4475

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address amanjunath421199@directwellstar.org Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20210611001082 GA Practitioner - Urology 8628375201 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
Northwestern University Feinberg Medical School, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Wellstar Medical Group LLCGroup PAC ID 6709065402, 3,059 clinicians

Practice addresses (Care Compare)

1700 Hospital S Dr
Austell, GA 30106-8116

2518 Jimmy Lee Smith Pkwy
Hiram, GA 30141-2068
Phone (770) 732-4022

3950 Austell Rd
Austell, GA 30106-1121
Phone (770) 732-4022

4441 Atlanta Rd SE
Smyrna, GA 30080-6443

5150 Stilesboro N W Rd
Suite 220
Kennesaw, GA 30152-7742
Phone (770) 424-8222

55 Whitcher Nest
Marietta, GA 30060-1169
Phone (770) 428-4475

55 Whitcher St
Suite 260
Marietta, GA 30060-1169
Phone (943) 202-7050

625 Church Nest
Marietta, GA 30060-1101
Phone (770) 422-2004

677 Church Nest
Marietta, GA 30060-1101

677 Church St NE
Suite 100P
Marietta, GA 30060-1101
Phone (470) 793-8585

8954 Hospital Dr
Douglasville, GA 30134-2272
Phone (678) 838-2585

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.93 of 100Reported as apm
Quality
82.14
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Prostate resection13

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
89159GAMDUrology Physician
036.145044ILMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wellstar Medical Group, LLC CurrentSince Jun 15, 2021 Accepting new patients
Wellstar Medical Group, LLC Current Accepting new patients

Locations

1700 Hospital South Dr
Ste 404
Austell, GA 30106
Phone (404) 645-8271

144 Bill Carruth Pkwy
Ste 2300
Hiram, GA 30141
Phone (770) 590-1078

5150 Stilesboro Rd NW
Ste 220
Kennesaw, GA 30152
Phone (770) 424-8222

805 Sandy Plains Rd
Marietta, GA 30066
Phone (770) 792-1616

Interoperability endpoints

  • Direct secure messaging: amanjunath421199@directwellstar.org

Organizations & group practices 2

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 6

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": "1421280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635292800000",
    "number": "1144619933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "144 BILL CARRUTH PKWY STE 2300",
            "city": "HIRAM",
            "state": "GA",
            "postal_code": "301413821",
            "telephone_number": "770-428-4475",
            "fax_number": "678-363-8836"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "251 E HURON ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606112908",
            "telephone_number": "312-926-2000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "144 Bill Carruth Pkwy Ste 2300",
            "address_purpose": "LOCATION",
            "city": "Hiram",
            "state": "GA",
            "postal_code": "301413821",
            "country_code": "US",
            "telephone_number": "770-428-4475",
            "fax_number": "678-363-8836",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MANJUNATH",
        "first_name": "ADARSH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-01-15",
        "last_updated": "2021-10-27",
        "certification_date": "2021-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "IL",
            "license": "036.145044",
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "GA",
            "license": "89159",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "amanjunath421199@directwellstar.org",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "144 Bill Carruth Pkwy Ste 2300",
            "city": "Hiram",
            "state": "GA",
            "country_code": "US",
            "postal_code": "301413821",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.