Individual provider Active NPI

Dwarka Rathi, MD

  • Nephrology Physician
  • Brookhaven, GA
National Provider Identifier
1528077732
Registry record updated Jan 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
86856 Issued in GA
Practice address
1561 Tryon Rd NE
Brookhaven, GA 30319-2940
Phone
(914) 643-3879
NPI assigned
Aug 5, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 12, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X 86856 GA Primary
Nephrology Physician 207RN0300X 205041-1 NY

Addresses

Primary practice location

1561 Tryon Rd NE
Brookhaven, GA 30319-2940

Mailing address

1561 Tryon Rd NE
Brookhaven, GA 30319-2940
Phone (146) 433-8799

Other identifiers 1

IdentifierTypeStateIssuer
01577820MedicaidNY

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
I20240108005350 GA Practitioner - Internal Medicine 0244309722 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
86856GAMDNephrology Physician
205041-1NYMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Thriving Lane CurrentSince Oct 1, 2023 Accepting new patients
Siv Ophthalmology PC PastSince Aug 3, 2011 Accepting new patients

Locations

200 2nd Ave S
St Petersburg, FL 33701
Phone (727) 465-8515

2801 Buford Hwy NE
Ste T10
Brookhaven, GA 30329
Phone (404) 397-8302

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1154736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705017600000",
    "number": "1528077732",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1561 TRYON RD NE",
            "city": "BROOKHAVEN",
            "state": "GA",
            "postal_code": "303192940",
            "telephone_number": "146-433-8799"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1561 TRYON RD NE",
            "city": "BROOKHAVEN",
            "state": "GA",
            "postal_code": "303192940",
            "telephone_number": "914-643-3879"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RATHI",
        "first_name": "DWARKA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-05",
        "last_updated": "2024-01-12",
        "certification_date": "2024-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "GA",
            "license": "86856",
            "primary": true
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "NY",
            "license": "205041-1",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01577820",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brookhaven, GA

Sources for this page

Verify at the official NPI Registry.