Indira GM Menon, M.D.

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

047623 Issued in GA

Practice address

1457 Scott Blvd
Decatur, GA 30030

Phone

(404) 292-2500

Fax

(404) 294-9361

NPI assigned

Aug 2, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Dr. Indira G Mamballikalathil Former name

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

Ophthalmology

Education

University of Alabama School of Medicine, 1996

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Eye Physicians and Surgeons PCGroup PAC ID 7214923069, 8 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

94.51 of 100Reported as apm

Quality

80.61

Promoting interoperability

100

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: imenon@atlantaeye.intellechartdirect.net

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.

• Eye Physicians and Surgeons PC

  • Ophthalmology Physician
  • Decatur, GA
  • NPI 1720011422
  Medicare reassignment Care Compare group NPD
• Eps Surgical Center, LLC

  • Ambulatory Surgical Clinic/Center
  • Decatur, GA
  • NPI 1922262278
  NPD (past)

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

{
    "created_epoch": "1122940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1164423075",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1798",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300311798",
            "telephone_number": "404-292-2500",
            "fax_number": "404-294-9361"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1457 SCOTT BLVD",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "30030",
            "telephone_number": "404-292-2500",
            "fax_number": "404-294-9361"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENON",
        "first_name": "INDIRA",
        "middle_name": "GM",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "GA",
            "license": "047623",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00837284A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "INDIRA",
            "last_name": "MAMBALLIKALATHIL",
            "middle_name": "G",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Charles Moyer Mendenhall III, PH.D.
• Marisa Isabel Mendes, RD, LD
• Natalie Mendez
• Delquis Rafael Mendoza, MD
• Victoria Jessica Menendez, DDS
• Mental Wellness Matters Treatment Center, LLC
• Mentally Free Psychiatry LLC
• Jay B. Mepani, M.D.
• Rozina Merchant, MD
• Merci-Joie Home Health Care LLC

• Ophthalmology Physician in Decatur, GA
• Providers in Decatur, GA by specialty
• Ophthalmology 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.