Active NPI
Satyanarayana M Divvela, MD
- Anesthesiology Physician
- Lawrenceville, GA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- License
- 075221
- Practice address
- 1000 Medical Center Blvd
Lawrenceville, GA 30046-7694 - Phone
- (770) 277-3056
- Fax
- (855) 204-5244
- NPI assigned
- Jun 7, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | 261642 | NY | |
| Hospitalist Physician | 208M00000X | 2007019093 | MO | |
| Anesthesiology Physician | 207L00000X | 075221 | GA | Primary |
Addresses
Primary practice location
1000 Medical Center Blvd
Lawrenceville, GA 30046-7694
Mailing address
PO Box 551420
Fort Lauderdale, FL 33355-1420
Phone (800) 243-3839
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20161115002328 | GA | Practitioner - Anesthesiology | 5991890261 | Reassigns benefits to 3 organizations |
Care Compare profile
Medicare Care Compare- Specialty
- Anesthesiology
- Education
- Other, 1999
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- North Atlanta Anesthesia Professionals, LLC
Practice addresses (Care Compare)
1000 Medical Ctr Blvd
Lawrenceville, GA 30046-7694
Phone (678) 312-1000
3620 Howell Ferry Rd
Duluth, GA 30096-3178
Phone (678) 312-6800
Hospital & facility affiliations
- Northside Hospital Gwinnett
- Northside Hospital Duluth
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2007019093 | MO | MD | Hospitalist Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| American Anesthesiology Associates of Georgia, LLC | Anesthesiology | Current | Accepting new patients |
| North Atlanta Anesthesia Professionals, LLC | Anesthesiology | Current | Accepting new patients |
| North Atlanta Professional Services LLC | Hospitalist | Current | Accepting new patients |
Locations
2701 N Decatur Rd
Decatur, GA 30033
Phone (404) 501-1000
1000 Medical Center Blvd
Lawrenceville, GA 30046
Phone (678) 312-3356
1000 Johnson Fy Rd NE
Sandy Springs, GA 30342
Phone (404) 851-1000
Organizations & group practices 3
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.
-
- Anesthesiology Physician
- Atlanta, GA
- NPI 1982349296
Anesthesiology, GA
-
- Anesthesiology Physician
- Stone Mountain, GA
- NPI 1528068673
Anesthesiology, GA
Hospital & facility affiliations 2
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": "1181174400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1478217600000",
"number": "1306049192",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 551420",
"city": "FORT LAUDERDALE",
"state": "FL",
"postal_code": "333551420",
"telephone_number": "800-243-3839",
"fax_number": "855-851-4405"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1000 MEDICAL CENTER BLVD",
"city": "LAWRENCEVILLE",
"state": "GA",
"postal_code": "300467694",
"telephone_number": "770-277-3056",
"fax_number": "855-204-5244"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DIVVELA",
"first_name": "SATYANARAYANA",
"middle_name": "M",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-06-07",
"last_updated": "2016-11-04",
"status": "A"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "NY",
"license": "261642",
"primary": false
},
{
"code": "208M00000X",
"taxonomy_group": "",
"desc": "Hospitalist",
"state": "MO",
"license": "2007019093",
"primary": false
},
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "GA",
"license": "075221",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Lawrenceville, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2016; 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.