Active NPI
Subra Kugathasan, MD
- Pediatric Gastroenterology Physician
- Atlanta, GA
National Provider Identifier
1497706238
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Gastroenterology Physician
- License
- 61111
- Practice address
- 1400 Tullie Rd NE FL 2
Atlanta, GA 30329-2309 - Phone
- (404) 785-5437
- Fax
- (404) 785-9042
- NPI assigned
- May 15, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Gastroenterology Physician | 2080P0206X | 61111 | GA | Primary |
Addresses
Primary practice location
1400 Tullie Rd NE FL 2
Atlanta, GA 30329-2309
Mailing address
1400 Tullie Rd NE FL 2
Atlanta, GA 30329-2309
Phone (404) 785-5437
Other names 1
- Subramaniam Kugathasan
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | choa@choa.gadirect.net |
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160511001103 | GA | Order and Referring Only - Gastroenterology | 6305902776 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 61111 | GA | MD | Pediatric Gastroenterology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Choa Multispecialty, LLC | Pediatric Gastroenterology | Past | Accepting new patients |
| Emory Childrens Center | Past | Accepting new patients | |
| Egleston Children'S Hospital at Emory University, Inc. | Past | Accepting new patients | |
| Hospital Authority of the City of Bainbridge and Decatur County | Past | Accepting new patients |
Interoperability endpoints
- skugathasan33896@choa.gadirect.net
Organizations & group practices 4
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.
-
- Pediatrics Physician
- Brookhaven, GA
- NPI 1437493467
Pediatric Gastroenterology
-
- Pediatric Emergency Medicine (Pediatrics) Physician
- Atlanta, GA
- NPI 1558416701
-
- Pediatrics Physician
- Atlanta, GA
- NPI 1558374322
-
- Multi-Specialty Clinic/Center
- Bainbridge, GA
- NPI 1053388256
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147651200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1645056000000",
"number": "1497706238",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1400 TULLIE RD NE FL 2",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303292309",
"telephone_number": "404-785-5437",
"fax_number": "404-785-9042"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1400 TULLIE RD NE FL 2",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303292309",
"telephone_number": "404-785-5437",
"fax_number": "404-785-9042"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KUGATHASAN",
"first_name": "SUBRA",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-15",
"last_updated": "2022-02-17",
"status": "A"
},
"taxonomies": [
{
"code": "2080P0206X",
"taxonomy_group": "",
"desc": "Pediatrics, Pediatric Gastroenterology",
"state": "GA",
"license": "61111",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "choa@choa.gadirect.net",
"affiliation": "N",
"address_1": "1400 Tullie Rd NE Fl 2",
"city": "Atlanta",
"state": "GA",
"country_code": "US",
"postal_code": "303292309",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": [
{
"first_name": "SUBRAMANIAM",
"last_name": "KUGATHASAN",
"code": "5",
"type": "Other Name"
}
]
}
Other providers in Atlanta, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.