NPIMap

Individual provider Active NPI

Sanjay Serrao, MD

  • Internal Medicine Physician
  • Jasper, GA
National Provider Identifier
1346204062
Registry record updated Jan 30, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
48016 Issued in GA
Practice address
220 J L White Dr
Ste 150
Jasper, GA 30143-4893
Phone
(706) 299-2200
NPI assigned
Apr 12, 2006
Last updated
Jan 30, 2017By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X ME94738 FL
Internal Medicine Physician 207R00000X 48016 GA Primary

Addresses

Primary practice location

220 J L White Dr
Ste 150
Jasper, GA 30143-4893

Mailing address

220 J L White Dr
Ste 150
Jasper, GA 30143-4893
Phone (706) 299-2200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051026000231 GA Practitioner - Internal Medicine 4880611250 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Piedmont Medical Care CorporationGroup PAC ID 6002802220, 368 clinicians

Practice addresses (Care Compare)

105 Collier Rd NW
Suite 5020
Atlanta, GA 30309-1731
Phone (404) 367-3210

220 J L White Dr
Suite 150
Jasper, GA 30143-4895
Phone (706) 299-2200

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
91.62 of 100Reported as apm
Quality
83.25
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Piedmont Hospitalist Physicians LLC Internal Medicine CurrentSince May 21, 2018 Accepting new patients
Piedmont Medical Care Corporation Internal Medicine CurrentSince Jan 30, 2017 Accepting new patients
Piedmont Providers LLC Internal Medicine Past Accepting new patients

Locations

105 Collier Rd NW
Ste 2070
Atlanta, GA 30309
Phone (404) 350-3860

105 Collier Rd NW
Ste 5020
Atlanta, GA 30309
Phone (404) 350-3860

35 Collier Rd NW
Ste 635
Atlanta, GA 30309
Phone (404) 367-3000

220 J L White Dr
Ste 150
Jasper, GA 30143
Phone (706) 253-2430

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 11

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": "1144800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1485734400000",
    "number": "1346204062",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "220 J L WHITE DR",
            "address_2": "STE 150",
            "city": "JASPER",
            "state": "GA",
            "postal_code": "301434893",
            "telephone_number": "706-299-2200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 J L WHITE DR",
            "address_2": "STE 150",
            "city": "JASPER",
            "state": "GA",
            "postal_code": "301434893",
            "telephone_number": "706-299-2200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SERRAO",
        "first_name": "SANJAY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-12",
        "last_updated": "2017-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME94738",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "48016",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jasper, GA

Sources for this page

Verify at the official NPI Registry.