Individual provider Active NPI

Binu James Kunjummen, M.D.

  • Interventional Cardiology Physician
  • Tucker, GA
National Provider Identifier
1437331196
Registry record updated Oct 7, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Cardiology PhysicianTaxonomy code 207RI0011X
License
065135 Issued in GA
Practice address
1468 Montreal Rd
Tucker, GA 30084-6901
Phone
(770) 638-1400
Fax
(770) 638-1411
NPI assigned
Dec 4, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 065135 GA
Interventional Cardiology Physician 207RI0011X 065135 GA Primary

Addresses

Primary practice location

1468 Montreal Rd
Tucker, GA 30084-6901

Mailing address

1468 Montreal Rd
Tucker, GA 30084-6901
Phone (770) 638-1400

Other identifiers 1

IdentifierTypeStateIssuer
003100222GMedicaidGA

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
I20110119000286 GA Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal MedicinePractitioner - Interventional Cardiology 7113106410 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)Also: Internal Medicine, Interventional Cardiology
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Atlanta Heart Specialists LLCGroup PAC ID 9537134341, 21 clinicians

Practice addresses (Care Compare)

1468 Montreal Rd
Tucker, GA 30084-6901
Phone (770) 638-1400

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
97.16 of 100Reported as group
Promoting interoperability
95
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting1-10
Varicose vein removal19
Leg revascularization (restoring blood flow)14

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
065135GAMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dekalb Medical Center, Inc. Current Accepting new patients
Outpatient Imaging, LLC Past Accepting new patients

Locations

2665 N Decatur Rd
Ste 320
Decatur, GA 30033
Phone (404) 292-1144

1468 Montreal Rd
Tucker, GA 30084
Phone (770) 638-1400

Interoperability endpoints

  • Direct secure messaging: binu.kunjummen@ahsmed.gadirect.net
  • Direct secure messaging: binu.kunjummen@ahs1468.eclinicaldirectplus.com
  • Direct secure messaging: binu.kunjummen@gadirect.net

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 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": "1196726400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1444176000000",
    "number": "1437331196",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1468 MONTREAL RD",
            "city": "TUCKER",
            "state": "GA",
            "postal_code": "300846901",
            "telephone_number": "770-638-1400",
            "fax_number": "770-638-1411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1468 MONTREAL RD",
            "city": "TUCKER",
            "state": "GA",
            "postal_code": "300846901",
            "telephone_number": "770-638-1400",
            "fax_number": "770-638-1411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUNJUMMEN",
        "first_name": "BINU",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-12-04",
        "last_updated": "2015-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "GA",
            "license": "065135",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "GA",
            "license": "065135",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003100222G",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucker, GA

Sources for this page

Verify at the official NPI Registry.