Radhika Mudiyala, M.D.

Primary specialty

Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X

License

051069 Issued in GA

Practice address

3606 Highlands Pkwy SE
BLDG # 1
Smyrna, GA 30082-5184

Phone

(678) 303-5082

Fax

(678) 303-5160

NPI assigned

May 25, 2006

Sex

Female

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

Geriatric MedicineAlso: Internal Medicine

Education

Other, 1993

Medicare assignment

May accept Medicare assignment

Telehealth

Offers telehealth services

Group practices

Matrix Rehabilitation-Georgia IncGroup PAC ID 2567379498, shared by 4 NPIs, 40 clinicians

Legacy Healthcare Services IncGroup PAC ID 2163339722, shared by 46 NPIs, 3,431 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Wellstar Cobb Medical Center Hospital, Austell, GA, CCN 110143
• Wellstar Douglas Medical Center Hospital, Douglasville, GA, CCN 110184
• Wellstar Windy Hill Hospital Long-term care hospital, Marietta, GA, CCN 112007

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

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

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.

• Smyrna Medical Associates, PC

  • Geriatric Medicine (Internal Medicine) Physician
  • Smyrna, GA
  • NPI 1558416198
  Medicare reassignment NPD Authorized official
• Cobb Kidney Center, PC

  • Nephrology Physician
  • Smyrna, GA
  • NPI 1326193939
  NPD (past)

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

• Cobb Hospital, Inc

  • General Acute Care Hospital
  • Austell, GA
  • NPI 1467420448
  Care Compare affiliation
• Douglas Hospital, Inc.

  • General Acute Care Hospital
  • Douglasville, GA
  • NPI 1649247974
  Care Compare affiliation
• Kennestone Hospital, Inc.

  • Long Term Care Hospital
  • Marietta, GA
  • NPI 1700853041

  Long-term care hospital

  Care Compare affiliation

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

{
    "created_epoch": "1148515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1250035200000",
    "number": "1336195254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3606 HIGHLANDS PKWY SE",
            "address_2": "BLDG # 1",
            "city": "SMYRNA",
            "state": "GA",
            "postal_code": "300825184",
            "telephone_number": "678-303-5082",
            "fax_number": "678-303-5160"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3606 HIGHLANDS PKWY SE",
            "address_2": "BLDG # 1",
            "city": "SMYRNA",
            "state": "GA",
            "postal_code": "300825184",
            "telephone_number": "678-303-5082",
            "fax_number": "678-303-5160"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUDIYALA",
        "first_name": "RADHIKA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-05-25",
        "last_updated": "2009-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "GA",
            "license": "051069",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "109113329A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mouthpeace Dental 5 LLC
• Moving Forward Consultant Company
• MPM Group LLC
• MTM Anesthesia, LLC
• Mudaris Healthcare LLC
• Fatimah N Muhammad
• Stephanie Nichole Mukangu, FNP
• Meghan Elizabeth Muldoon
• Leanne K Mullis
• Arun K Munjal, M.D

• Geriatric Medicine (Internal Medicine) Physician in Smyrna, GA
• Providers in Smyrna, GA by specialty
• Geriatric Medicine (Internal Medicine) Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2009; 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.