Individual provider Active NPI

Praveen Rastogi, MD, FCCP, ABSM

  • Sleep Specialist (PhD)
  • Stockbridge, GA
National Provider Identifier
1265406375
Registry record updated Mar 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sleep Specialist (PhD)Taxonomy code 173F00000X
License
26176 Issued in GA
Practice address
915 Eagles Landing Pkwy
Stockbridge, GA 30281-5011
Phone
(770) 996-6699
Fax
(770) 997-4790
NPI assigned
Feb 15, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2022

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine (Internal Medicine) Physician 207RC0200X 26176 GA
Pulmonary Disease Physician 207RP1001X 26176 GA
Sleep Medicine (Internal Medicine) Physician 207RS0012X 26176 GA
Sleep Specialist (PhD) 173F00000X 26176 GA Primary

Addresses

Primary practice location

915 Eagles Landing Pkwy
Stockbridge, GA 30281-5011

Mailing address

915 Eagles Landing Pkwy
Stockbridge, GA 30281-5011
Phone (770) 996-6699

Other identifiers 1

IdentifierTypeStateIssuer
002866668AMedicaidGA

Other names 1

  • Praveen Rastogi Professional name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address prastogi@psma.gwaydirect.com Direct

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
I20050811000854 GA Practitioner - Critical Care (Intensivists)Practitioner - Internal MedicinePractitioner - Pulmonary Disease 3072427806 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Critical Care (Intensivists)Also: Internal Medicine, Pulmonary Disease
Education
Other, 1976
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pulmonary and Sleep Medicine Associates, LLPGroup PAC ID 9931013760, 5 clinicians

Practice addresses (Care Compare)

915 Eagles Landing Pkwy
Stockbridge, GA 30281-5011
Phone 7709966699151

Hospital & facility affiliations

  • Piedmont Henry Hospital Hospital, Stockbridge, GA, CCN 110191
  • Piedmont Fayette Hospital Hospital, Fayetteville, GA, CCN 110215
  • Northside Hospital Hospital, Atlanta, GA, CCN 110161

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
26176GAMDSleep Medicine (Internal Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pulmonary & Sleep Medicine Associates, LLP CurrentSince Jul 1, 1966 Accepting new patients

Locations

132 Old Norton Rd
Ste 101
Fayetteville, GA 30215
Phone (770) 692-9501

6572 River Park Dr
Ste 101
Riverdale, GA 30274
Phone (678) 626-1833

11 Upper Riverdale Rd SW
Riverdale, GA 30274
Phone (770) 897-7277

915 Eagles Landing Pkwy
Stockbridge, GA 30281
Phone (770) 506-4350

1133 Eagles Landing Pkwy
Stockbridge, GA 30281
Phone (678) 604-1000

Interoperability endpoints

  • FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.441.1123

Organizations & group practices 1

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 3

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": "1139961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646352000000",
    "number": "1265406375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "915 EAGLES LANDING PKWY",
            "city": "STOCKBRIDGE",
            "state": "GA",
            "postal_code": "302815011",
            "telephone_number": "770-996-6699",
            "fax_number": "770-997-4790"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "915 EAGLES LANDING PKWY",
            "city": "STOCKBRIDGE",
            "state": "GA",
            "postal_code": "302815011",
            "telephone_number": "770-996-6699",
            "fax_number": "770-997-4790"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RASTOGI",
        "first_name": "PRAVEEN",
        "credential": "MD, FCCP, ABSM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-15",
        "last_updated": "2022-03-04",
        "certification_date": "2022-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "GA",
            "license": "26176",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "GA",
            "license": "26176",
            "primary": false
        },
        {
            "code": "207RS0012X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Sleep Medicine",
            "state": "GA",
            "license": "26176",
            "primary": false
        },
        {
            "code": "173F00000X",
            "taxonomy_group": "",
            "desc": "Sleep Specialist, PhD",
            "state": "GA",
            "license": "26176",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002866668A",
            "state": "GA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "prastogi@psma.gwaydirect.com",
            "affiliation": "N",
            "endpointDescription": "prastogi@psma.gwaydirect.com",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "915 Eagles Landing Pkwy",
            "city": "Stockbridge",
            "state": "GA",
            "country_code": "US",
            "postal_code": "302815011",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "PRAVEEN",
            "last_name": "RASTOGI",
            "credential": "MD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Stockbridge, GA

Sources for this page

Verify at the official NPI Registry.