Shailendra Kapoor, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

076590 Issued in GA

Practice address

1100 Lake Hearn Dr Ste 250&500
Kaiser Permanente Sandy Springs Medical Center
Sandy Springs, GA 30342-1523

Phone

(404) 845-4500

Fax

(804) 741-6213

NPI assigned

Mar 9, 2008

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 3

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

Family Practice

Education

Other, 2000

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

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
• Bon Secours St Francis Medical Center LLC

  • Surgery Physician
  • Midlothian, VA
  • NPI 1083841936
  NPD (past)
• Bon Secours St. Francis Medical Center Inc

  • Neurology Physician
  • Chester, VA
  • NPI 1811228711
  NPD (past)
• Bon Secours St. Francis Medical Center LLC

  • Internal Medicine Physician
  • Midlothian, VA
  • NPI 1053698399
  NPD (past)
• Bon Secours-St. Mary'S Hospital of Richmond, Inc.

  • Infectious Disease Physician
  • Richmond, VA
  • NPI 1063772143
  NPD (past)
• Bon Secours-St. Mary'S Hospital of Richmond, Inc.

  • Family Medicine Physician
  • Richmond, VA
  • NPI 1942598693
  NPD (past)
• Cherokee Health Systems

  • Federally Qualified Health Center (FQHC)
  • Talbott, TN
  • NPI 1134128820

  Family Medicine

  NPD (past)

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

{
    "created_epoch": "1205020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641772800000",
    "number": "1184894859",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3495 PIEDMONT RD NE",
            "address_2": "NINE PIEDMONT CENTER",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303051717",
            "telephone_number": "404-504-5678",
            "fax_number": "804-741-6213"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 LAKE HEARN DR STE 250&500",
            "address_2": "KAISER PERMANENTE SANDY SPRINGS MEDICAL CENTER",
            "city": "SANDY SPRINGS",
            "state": "GA",
            "postal_code": "303421523",
            "telephone_number": "404-845-4500",
            "fax_number": "804-741-6213"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAPOOR",
        "first_name": "SHAILENDRA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-03-09",
        "last_updated": "2022-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "0101245670",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036.119478",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "076590",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP PTAN",
            "identifier": "C09633",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP PTAN",
            "identifier": "C05698",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP PTAN",
            "identifier": "C06778",
            "state": "VA"
        }
    ],
    "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": "1100 Lake Hearn Dr",
            "city": "Atlanta",
            "state": "GA",
            "country_code": "US",
            "postal_code": "303421523",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Kaiser Foundation Health Plan of Georgia
• Tammy Kay Kaiser, BCBA
• Kaizen Healthcare
• Vamsi Kanagala, M.D.
• Pearl Kang
• David Merab Katz, M.D.
• Paul L Kaufman, M.D.
• Kay Group Limited
• Kaylee Goss LLC
• Dasha Dmitri Kazmin

• Family Medicine Physician in Sandy Springs, GA
• Providers in Sandy Springs, GA by specialty
• Family Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 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.