Individual provider Active NPI

Jithendranath Palacherla, MD

  • Internal Medicine Physician
  • Snellville, GA
National Provider Identifier
1346288735
Registry record updated Oct 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
059304 Issued in GA
Practice address
1567 Janmar Road
Suite 100
Snellville, GA 30078
Phone
(770) 972-1022
NPI assigned
Jun 4, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X M0853 TX
Nephrology Physician 207RN0300X 059304 GA
Internal Medicine Physician 207R00000X 059304 GA Primary

Addresses

Primary practice location

1567 Janmar Road
Suite 100
Snellville, GA 30078

Mailing address

1567 Janmar Road
Suite 100
Snellville, GA 30078
Phone (770) 972-1022

Other identifiers 1

IdentifierTypeStateIssuer
8R9118OtherTXBLUE SHIELD

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
I20191031000411 GA Practitioner - Nephrology 0547247249 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nephrology
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Metro Nephrology, IncGroup PAC ID 4183778046, 2 clinicians

Practice addresses (Care Compare)

11810 Northfall LN
Suite 1202
Alpharetta, GA 30009-7975
Phone (770) 663-8761

Hospital & facility affiliations

  • Fresenius Kidney Care North Forsyth Dialysis facility, Cumming, GA, CCN 852563
  • Usrc Roswell Dialysis facility, Roswell, GA, CCN 112845
  • Concerto Georgia LLC Dialysis facility, Austell, GA, CCN 852576
  • Wellstar North Fulton Medical Center Hospital, Roswell, GA, CCN 110198
  • Northside Hospital Forsyth Hospital, Cumming, GA, CCN 110005
  • Wellstar Kennestone Regional Medical Center Hospital, Marietta, GA, CCN 110035
  • Wellstar Cobb Medical Center Hospital, Austell, GA, CCN 110143
  • Northside Hospital Hospital, Atlanta, GA, CCN 110161

Merit-based Incentive Payment System (MIPS)

Final score
46.49 of 100Reported as individual
Quality
52.13
Improvement activities
0
Cost
66.42

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Metro Nephrology, Inc Nephrology CurrentSince Mar 1, 2021 Accepting new patients
North Atlanta Heart & Vascular Centre Past Accepting new patients
Acs Primary Care Physicians Southwest, PA Internal Medicine Past Accepting new patients
RG Wagner MD LLC Internal Medicine PastSince Aug 1, 2006 Accepting new patients

Locations

11810 Northfall Ln
Ste 1202
Alpharetta, GA 30009
Phone (770) 663-8761

6002 Highway 53 E
Ste 130
Dawsonville, GA 30534
Phone (706) 265-8002

11660 Alpharetta Hwy
Ste 650
Roswell, GA 30076
Phone (678) 710-0970

Interoperability endpoints

  • Direct secure messaging: jithendranath.palacherla@direct.davitaphysiciansolutions.com

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 and National Provider Directory roles.

Hospital & facility affiliations 8

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": "1149379200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602547200000",
    "number": "1346288735",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1567 JANMAR ROAD",
            "address_2": "SUITE 100",
            "city": "SNELLVILLE",
            "state": "GA",
            "postal_code": "30078",
            "telephone_number": "770-972-1022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1567 JANMAR ROAD",
            "address_2": "SUITE 100",
            "city": "SNELLVILLE",
            "state": "GA",
            "postal_code": "30078",
            "telephone_number": "770-972-1022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PALACHERLA",
        "first_name": "JITHENDRANATH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-04",
        "last_updated": "2020-10-13",
        "certification_date": "2020-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "M0853",
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "GA",
            "license": "059304",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "059304",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "8R9118",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Snellville, GA

Sources for this page

Verify at the official NPI Registry.