Individual provider Active NPI

Raynusha Pillai

  • Nurse Practitioner
  • Atlanta, GA
National Provider Identifier
1407488679
Registry record updated Aug 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
RN275630 Issued in GA
Practice address
80 Jesse Hill Jr Dr SE
Atlanta, GA 30303-3031
Phone
(404) 616-1000
NPI assigned
Feb 6, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN275630 GA
Nurse Practitioner 363L00000X RN275630 GA Primary

Addresses

Primary practice location

80 Jesse Hill Jr Dr SE
Atlanta, GA 30303-3031

Mailing address

1365 Clifton Rd NE Ste B6168
Atlanta, GA 30322-1013
Phone (404) 778-3094

Other practice location 1

1365 Clifton Rd NE Ste B6168
Atlanta, GA 30322-1888
Phone (404) 778-3094

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200917001659 GA Practitioner - Nurse Practitioner 2567880883 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Emory Medical Care Foundation IncGroup PAC ID 4981501814, 1,003 clinicians

Practice addresses (Care Compare)

80 Jesse Hill Jr Dr SE
Atlanta, GA 30303-3031
Phone (404) 616-1000

Hospital & facility affiliations

  • Grady Memorial Hospital Hospital, Atlanta, GA, CCN 110079

Merit-based Incentive Payment System (MIPS)

Final score
93.24 of 100Reported as group
Quality
73.72
Promoting interoperability
100
Improvement activities
40
Cost
75.22

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RN275630GAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Emory Medical Care Foundation Inc CurrentSince Jul 5, 2020 Accepting new patients
Emory Medical Care Foundation Inc Nurse Practitioner CurrentSince Jul 5, 2020 Accepting new patients

Locations

80 Jesse Hill Jr Dr SE
Atlanta, GA 30303
Phone (404) 616-4370

1365 Clifton Rd NE
Ste B6168
Atlanta, GA 30322
Phone (404) 778-3094

101 W Ponce de Leon Ave
Decatur, GA 30030
Phone (404) 778-4889

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 and National Provider Directory roles.

Hospital & facility affiliations 1

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": "1580947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598572800000",
    "number": "1407488679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1365 CLIFTON RD NE STE B6168",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303221013",
            "telephone_number": "404-778-3094"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "80 JESSE HILL JR DR SE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303033031",
            "telephone_number": "404-616-1000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1365 Clifton Rd NE Ste B6168",
            "address_purpose": "LOCATION",
            "city": "Atlanta",
            "state": "GA",
            "postal_code": "303221888",
            "country_code": "US",
            "telephone_number": "404-778-3094",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PILLAI",
        "first_name": "RAYNUSHA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-02-06",
        "last_updated": "2020-08-28",
        "certification_date": "2020-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "GA",
            "license": "RN275630",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "GA",
            "license": "RN275630",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.