Manasa Vasireddy, MD
Individual provider Active NPI Internal Medicine Physician · Ballground, GA
NPI 1366020356 · NPPES record last updated Sep 3, 2024
Key facts
- NPI
- 1366020356
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Internal Medicine Physician 207R00000X
- License
- 101364 (GA)
- Practice address
- 8111 Ball Ground Hwy
Ballground, GA 30107 - Phone
- (770) 268-4315
- NPI assigned
- Mar 31, 2021
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 5
Medicare Care Compare profile
- Specialty
- Internal Medicine
- Education
- Other, 2024
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Aylo Health, LLC
Practice addresses (Care Compare)
8111 Ball Ground Hwy
Ball Ground, GA 30107-3936
Phone (770) 914-0116
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in GA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20241108000417 | GA | Practitioner - Internal Medicine | 8820479744 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 14046 | GA | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Aylo Health, LLC | Current |
Accepting new patients | |
| Aylo Health, LLC | Current |
Accepting new patients | |
| Aylo Health, LLC | Past | Accepting new patients | |
| Aylo Health, LLC | Past | Accepting new patients | |
| Aylo Health, LLC | Past | Accepting new patients |
Locations
3333 Riverwood Pkwy SE
Ste 250
Atlanta, GA 30339
Phone (770) 914-0016
8111 Ball Ground Hwy
Ball Ground, GA 30107
Phone (770) 268-4011
6613 Hickory Flat Hwy
Canton, GA 30115
Phone (770) 268-4357
3290 Sixes Rd
Canton, GA 30114
Phone (678) 374-7514
145 Eagles Walk
Ste A
Stockbridge, GA 30281
Phone (770) 389-3855
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Internal Medicine Physician | 207R00000X | 101364 | GA | Yes |
Addresses
Primary practice location
8111 Ball Ground Hwy
Ballground, GA 30107
Mailing address
3333 Riverwood Pkwy SE Ste 250
Atlanta, GA 30339-3304
Phone (770) 914-0116
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 3, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.