Northeast Georgia Surgery Center

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

NORTHEAST GEORGIA SURGERY CENTER

Practice address

601 Broad St SE Ste E
Gainesville, GA 30501-3718

Phone

(678) 971-4227

Fax

(678) 971-4238

NPI assigned

Dec 3, 2020

Organization subpart

No

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

Authorized official

Name

Ankur PatelNPI 1780971994

Title

Owner

Phone

(678) 971-4227

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Listed as

Northeast Georgia Surgery Center LLCCCN 11C0001543

Medicare certification status

ActiveFrom the Provider of Services file

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Ankur Bharat Patel, D.O.

  • Pain Medicine (Anesthesiology) Physician
  • Gainesville, GA
  • NPI 1780971994

  GA

  Medicare reassignment NPD Authorized official
• Sushanth Raghu Boda, DO

  • Interventional Pain Medicine Physician
  • Newnan, GA
  • NPI 1780114975

  GA

  Medicare reassignment NPD
• Evesha Kenya Kenlyn

  • Pain Medicine (Anesthesiology) Physician
  • Atlanta, GA
  • NPI 1477012656

  GA

  Medicare reassignment NPD
• Margaret Ann Riso, M.D.

  • Pain Medicine (Anesthesiology) Physician
  • Gainesville, GA
  • NPI 1417337320

  GA

  Medicare reassignment NPD
• Jordan Lee Tate, M.D., MPH

  • Interventional Pain Medicine Physician
  • Jasper, GA
  • NPI 1508008079

  GA

  Medicare reassignment NPD

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

{
    "created_epoch": "1606953600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1771545600000",
    "number": "1265037600",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 BROAD ST SE STE E",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305013718",
            "telephone_number": "678-971-4167",
            "fax_number": "833-989-2501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 BROAD ST SE STE E",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305013718",
            "telephone_number": "678-971-4227",
            "fax_number": "678-971-4238"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHEAST GEORGIA SURGERY CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-12-03",
        "last_updated": "2026-02-20",
        "certification_date": "2026-02-20",
        "status": "A",
        "authorized_official_last_name": "PATEL",
        "authorized_official_first_name": "ANKUR",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "678-971-4227"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Northeast Georgia Plastic Surgery Associates, Plastic Surgery Center
• Northeast Georgia Podiatry LLC
• Northeast Georgia Rehabilitation Hospital LLC
• Northeast Georgia Specialty Group LLC
• Northeast Georgia Speech Center, Inc.
• Northeast Georgia Surgical Associates PC
• Northeast Georgia Urological Assoc., P.C.
• Northeast Georgia Urological Surgery Center, LLC
• Northeast Georgia Vascular Center
• Northland Hearing Centers, Inc

• All providers in Gainesville, GA
• Ambulatory Surgical Clinic/Center in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.