Suresh R Gudur, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

042590 Issued in GA

Practice address

416 Pirkle Ferry Rd
Ste G100
Cumming, GA 30040-9202

Phone

(770) 205-5720

Fax

(770) 205-5841

NPI assigned

Aug 26, 2005

Reactivated

May 10, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 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: Family Practice, Geriatric Medicine

Education

Other, 1989

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Hospital & facility affiliations

• Northside Hospital Forsyth Hospital, Cumming, GA, CCN 110005
• Northside Hospital Hospital, Atlanta, GA, CCN 110161
• Wellstar North Fulton Medical Center Hospital, Roswell, GA, CCN 110198

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/DECCDA/Endpoint/DECCDA

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.

• GS Reddy Inc

  dba Cumming Medical Center

  • Internal Medicine Physician
  • Cumming, GA
  • NPI 1821326547
  Medicare reassignment NPD Authorized official

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

• Northside Hospital, Inc.

  dba Northside Hospital Forsyth

  • General Acute Care Hospital
  • Cumming, GA
  • NPI 1376574277
  Care Compare affiliation
• Northside Hospital, Inc.

  dba Northside Hospital

  • General Acute Care Hospital
  • Atlanta, GA
  • NPI 1457396079
  Care Compare affiliation
• Wellstar North Fulton Hospital, Inc

  dba WellStar North Fulton Hospital

  • General Acute Care Hospital
  • Roswell, GA
  • NPI 1750312997
  Care Compare affiliation

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

{
    "created_epoch": "1125014400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1312934400000",
    "number": "1235122920",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "416 PIRKLE FERRY RD",
            "address_2": "STE G100",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "300409202",
            "telephone_number": "770-205-5720",
            "fax_number": "770-205-5841"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "416 PIRKLE FERRY RD",
            "address_2": "STE G100",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "300409202",
            "telephone_number": "770-205-5720",
            "fax_number": "770-205-5841"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUDUR",
        "first_name": "SURESH",
        "middle_name": "R",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-26",
        "last_updated": "2011-08-10",
        "deactivation_date": "2006-03-27",
        "reactivation_date": "2006-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "042590",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000720277E",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• GS Eyecare
• GS Reddy Inc (Cumming Medical Center)
• Guardian Angels Home Care LLC
• Guardian Assisted Transportation
• Praveen Reddy Gudipati, DMD
• Jennifer Guerra
• Anthony G Guerrero, O.D
• Linda Gisselle Guerrero, RBT
• Natalie Davis Guetarni, LPC
• George Nelson Guild III, M.D.

• Internal Medicine Physician in Cumming, GA
• Providers in Cumming, GA by specialty
• Internal Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2011; 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.