Gautham Kanagaraj, M.D.

Primary specialty

Clinical Cardiac Electrophysiology PhysicianTaxonomy code 207RC0001X

License

103145 Issued in GA

Practice address

200 S Enota Dr NE Ste 480
Gainesville, GA 30501-3473

Phone

(770) 219-0950

Fax

(770) 534-8025

NPI assigned

May 21, 2012

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Enrolled in FL, GA2 enrollments

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 2

Specialty

Cardiac Electrophysiology

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Georgia Heart Institute LLCGroup PAC ID 4183848062, 127 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Northeast Georgia Medical Center, Inc Hospital, Gainesville, GA, CCN 110029
• NGMC Barrow, LLC Hospital, Winder, GA, CCN 110045
• Northeast Georgia Medical Center Habersham Hospital, Demorest, GA, CCN 110041
• Northside Hospital Hospital, Atlanta, GA, CCN 110161
• Northeast Georgia Medical Center Lumpkin Hospital, Dahlonega, GA, CCN 110237

Merit-based Incentive Payment System (MIPS)

Final score

88.62 of 100Reported as group

Quality

75.95

Improvement activities

40

Cost

81.48

Merit-based Incentive Payment System (MIPS)

Final score

84 of 100Reported as group

Quality

84.73

Promoting interoperability

89

Improvement activities

40

Cost

71.09

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Georgia Heart Institute LLC

  • Cardiovascular Disease Physician
  • Gainesville, GA
  • NPI 1477976520
  Medicare reassignment Care Compare group NPD
• South Shore Cardiovascular Associates Inc

  • Cardiovascular Disease Physician
  • Brandon, FL
  • NPI 1912175290
  Medicare reassignment NPD
• Northeast Georgia Heart Center

  • Cardiovascular Disease Physician
  • Gainesville, GA
  • NPI 1508812421
  NPD
• Castle Medical Center

  • Skilled Nursing Facility
  • Kailua, HI
  • NPI 1679556492
  NPD (past)

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

• NGMC Barrow LLC

  • General Acute Care Hospital
  • Winder, GA
  • NPI 1881144889
  Care Compare affiliation
• NGMC Lumpkin, LLC

  • General Acute Care Hospital
  • Dahlonega, GA
  • NPI 1083174973
  Care Compare affiliation
• Northeast Georgia Medical Center Habersham LLC

  • General Acute Care Hospital
  • Demorest, GA
  • NPI 1740981430
  Care Compare affiliation
• Northeast Georgia Medical Center, Inc.

  • General Acute Care Hospital
  • Gainesville, GA
  • NPI 1427055821
  Care Compare affiliation
• Northside Hospital, Inc.

  • General Acute Care Hospital
  • Atlanta, GA
  • NPI 1457396079
  Care Compare affiliation

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

{
    "created_epoch": "1337558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742515200000",
    "number": "1316207624",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1060",
            "city": "OAKWOOD",
            "state": "GA",
            "postal_code": "305660018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 S ENOTA DR NE STE 480",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305013473",
            "telephone_number": "770-219-0950",
            "fax_number": "770-534-8025"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "550 S Beretania St Ste 610",
            "address_purpose": "LOCATION",
            "city": "Honolulu",
            "state": "HI",
            "postal_code": "968132496",
            "country_code": "US",
            "telephone_number": "808-691-8512",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "13127 Vail Ridge Dr",
            "address_purpose": "LOCATION",
            "city": "Riverview",
            "state": "FL",
            "postal_code": "335797196",
            "country_code": "US",
            "telephone_number": "813-661-6199",
            "fax_number": "813-661-6334",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KANAGARAJ",
        "first_name": "GAUTHAM",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-05-21",
        "last_updated": "2025-03-21",
        "certification_date": "2025-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "HI",
            "license": "MD-18039",
            "primary": false
        },
        {
            "code": "207RC0001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Clinical Cardiac Electrophysiology",
            "state": "HI",
            "license": "MD-18039",
            "primary": false
        },
        {
            "code": "207RC0001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Clinical Cardiac Electrophysiology",
            "state": "FL",
            "license": "ME16789",
            "primary": false
        },
        {
            "code": "207RC0001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Clinical Cardiac Electrophysiology",
            "state": "GA",
            "license": "103145",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael Kallab, CAA
• Ukoha Agbai Kalu, MD
• Devaki Kalvapudi
• Sunitha Kalyanam, M.D.
• Susan Kammerer
• Swathi Kanakamedala, DO
• Ines K Kananda, DO
• Stefanie Kananda, D.O.
• Vamsi Krishna Kancherla, MD
• Eliza Soojung Kang

• Clinical Cardiac Electrophysiology Physician in Gainesville, GA
• Providers in Gainesville, GA by specialty
• Clinical Cardiac Electrophysiology Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2025; 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.