Individual provider Active NPI

Jinu Pravin Kamdar, M.D.

  • Surgery Physician
  • Marietta, GA
National Provider Identifier
1477526309
Registry record updated Feb 17, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
62368 Issued in GA
Practice address
55 Whitcher St NE
Suite 130
Marietta, GA 30060-1155
Phone
(770) 428-0462
Fax
(770) 427-8001
NPI assigned
Feb 10, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 62368 GA Primary

Addresses

Primary practice location

55 Whitcher St NE
Suite 130
Marietta, GA 30060-1155

Mailing address

55 Whitcher St NE
Suite 130
Marietta, GA 30060-1155
Phone (770) 428-0462

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
I20090729000776 GA Practitioner - General Surgery 9739232349 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
University of Wisconsin School of Medicine, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Emory Medical Care Foundation Inc 1,003 clinicians

Practice addresses (Care Compare)

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

Correll Pavilion
80 Gilmer St.SE
Atlanta, GA 30303-9998
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

Merit-based Incentive Payment System (MIPS)

Final score
94.51 of 100Reported as apm
Quality
80.61
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hernia repair - groin (open)1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
62368GAMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wellstar Medical Group, LLC CurrentSince Aug 1, 2011 Accepting new patients
Wellstar Medical Group, LLC CurrentSince Aug 1, 2011 Accepting new patients
Emory Medical Care Foundation Inc CurrentSince Jun 19, 2023 Accepting new patients
Southern Regional Physicians Management Group, LLC Surgery CurrentSince Jan 2, 2018 Accepting new patients
The Emory Clinic Inc CurrentSince Jun 19, 2023 Accepting new patients
Emory Medical Care Foundation Inc Surgery CurrentSince Jun 19, 2023 Accepting new patients
Wellstar Medical Group, LLC Current Accepting new patients
Wellstar Cardiovascular Medicine, LLC Past Accepting new patients
Wellstar Medical Group, LLC Surgery Past Accepting new patients
Emory Health Care Past Accepting new patients

Locations

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

1365 Clifton Rd NE
Atlanta, GA 30322
Phone (404) 778-7525

4007 Flat Shoals Pkwy
Decatur, GA 30034
Phone (404) 616-5711

601 S 8th St
Griffin, GA 30224
Phone (770) 228-2721

5150 Stilesboro Rd NW
Ste 120
Kennesaw, GA 30152
Phone (678) 354-0230

5150 Stilesboro Rd NW
Ste 220
Kennesaw, GA 30152
Phone (770) 424-8222

805 Sandy Plains Rd
Marietta, GA 30066
Phone (770) 792-1616

55 Whitcher St NE
Ste 130
Marietta, GA 30060
Phone (770) 426-1629

677 Church St NE
Marietta, GA 30060
Phone (770) 793-5435

11 Upper Riverdale Rd SW
Riverdale, GA 30274
Phone (770) 897-7277

11 Upper Riverdale Rd SW
Ste 21
Riverdale, GA 30274

Interoperability endpoints

  • Direct secure messaging: jkamdar@direct.southernregional.org
  • Direct secure messaging: jkamdar23041@directwellstar.org

Organizations & group practices 10

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": "1139529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1455667200000",
    "number": "1477526309",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 WHITCHER ST NE",
            "address_2": "SUITE 130",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300601155",
            "telephone_number": "770-428-0462",
            "fax_number": "770-427-8001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 WHITCHER ST NE",
            "address_2": "SUITE 130",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300601155",
            "telephone_number": "770-428-0462",
            "fax_number": "770-427-8001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAMDAR",
        "first_name": "JINU",
        "middle_name": "PRAVIN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-10",
        "last_updated": "2016-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "GA",
            "license": "62368",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marietta, GA

Sources for this page

Verify at the official NPI Registry.