Individual provider Active NPI

Kavita Perumal Krishnasamy, M.D.

  • Clinical Cardiac Electrophysiology Physician
  • Fayetteville, GA
National Provider Identifier
1407099575
Registry record updated Aug 22, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Cardiac Electrophysiology PhysicianTaxonomy code 207RC0001X
License
83131 Issued in GA
Practice address
1267 Highway 54 W Ste 4100
Fayetteville, GA 30214-2112
Phone
(770) 506-5470
Fax
(770) 506-5471
NPI assigned
Apr 19, 2009
Last updated
Aug 22, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Cardiac Electrophysiology Physician 207RC0001X 83131 GA Primary

Addresses

Primary practice location

1267 Highway 54 W Ste 4100
Fayetteville, GA 30214-2112

Mailing address

1267 Highway 54 W Ste 4100
Fayetteville, GA 30214-2112
Phone (770) 506-5470

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
I20190909000771 GA Practitioner - Cardiac ElectrophysiologyPractitioner - Cardiovascular Disease (Cardiology) 3072742162 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiac ElectrophysiologyAlso: Cardiovascular Disease (Cardiology)
Education
Northeastern Ohio University College of Medicine, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Piedmont Cardiology of Atlanta, LLCGroup PAC ID 0345321691, 478 clinicians

Practice addresses (Care Compare)

1267 Hwy 54 W
Suite 2200
Fayetteville, GA 30214
Phone (770) 716-0051

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

Procedures performed for Medicare patients

ProcedureNumber of procedures
Pacemaker insertion or repair40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Piedmont Cardiology of Atlanta, LLC Cardiovascular Disease CurrentSince Aug 19, 2019 Accepting new patients
Piedmont Athens Specialty Care LLC Cardiovascular Disease Past Accepting new patients

Locations

1968 Ptree Rd NW
Atlanta, GA 30309
Phone (404) 605-2222

2727 Paces Ferry Rd SE
Ste 1-1100
Atlanta, GA 30339
Phone (470) 271-3421

95 Collier Rd NW
Ste 6000
Atlanta, GA 30309
Phone (404) 605-2888

1412 Milstead Ave NE
Conyers, GA 30012
Phone (770) 918-3000

1267 Highway 54 W
Ste 2200
Fayetteville, GA 30214
Phone (470) 271-3415

1267 Highway 54 W
Ste 4100
Fayetteville, GA 30214
Phone (770) 506-5470

1267 Highway 54 W
Ste 5200
Fayetteville, GA 30214
Phone (770) 460-9777

795 Poplar Rd
Ste 400
Newnan, GA 30265
Phone (770) 254-6089

6115 Peachtree Dunwoody Rd
Ste 300
Sandy Springs, GA 30328
Phone (404) 851-5400

20 Francis Way
Ste 101
Sharpsburg, GA 30277
Phone (404) 352-1611

Organizations & group practices 2

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 3

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": "1240099200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566432000000",
    "number": "1407099575",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1267 HIGHWAY 54 W STE 4100",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302142112",
            "telephone_number": "770-506-5470",
            "fax_number": "770-506-5471"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1267 HIGHWAY 54 W STE 4100",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302142112",
            "telephone_number": "770-506-5470",
            "fax_number": "770-506-5471"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRISHNASAMY",
        "first_name": "KAVITA",
        "middle_name": "PERUMAL",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-04-19",
        "last_updated": "2019-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Clinical Cardiac Electrophysiology",
            "state": "GA",
            "license": "83131",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, GA

Sources for this page

Verify at the official NPI Registry.