Individual provider Active NPI

Madhusudan Chandora, M.D.

  • Internal Medicine Physician
  • Stone Mountain, GA
National Provider Identifier
1376682971
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
038143 Issued in GA
Practice address
833 N Hairston Rd
Stone Mountain, GA 30083-3423
Phone
(770) 879-5553
NPI assigned
Feb 6, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 038143 GA Primary

Addresses

Primary practice location

833 N Hairston Rd
Stone Mountain, GA 30083-3423

Mailing address

833 N Hairston Rd
Stone Mountain, GA 30083-3423

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
I20050103000876 GA Practitioner - Internal Medicine 1052379328 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Athens Family Medicine LLC 14 clinicians

Practice addresses (Care Compare)

892 Prince Ave
Athens, GA 30606-2724
Phone (706) 227-2027

Hospital & facility affiliations

  • St Mary'S Hospital Hospital, Athens, GA, CCN 110006
  • Piedmont Athens Regional Medical Center Hospital, Athens, GA, CCN 110074

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Athens Family Medicine LLC CurrentSince May 1, 2024 Accepting new patients
Gwinnett Cardiology Services LLC Past Accepting new patients
Patriot Healthcare of Georgia, LLC Past Accepting new patients

Locations

300 Hawthorne Ln
Athens, GA 30606
Phone (706) 353-7348

892 Prince Ave
Athens, GA 30606
Phone (706) 227-2027

Organizations & group practices 3

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 2

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": "1170720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1376682971",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "833 N HAIRSTON RD",
            "city": "STONE MOUNTAIN",
            "state": "GA",
            "postal_code": "300833423"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "833 N HAIRSTON RD",
            "city": "STONE MOUNTAIN",
            "state": "GA",
            "postal_code": "300833423",
            "telephone_number": "770-879-5553"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHANDORA",
        "first_name": "MADHUSUDAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-06",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "038143",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stone Mountain, GA

Sources for this page

Verify at the official NPI Registry.