NPIMap

Individual provider Active NPI

Venkatappa Rangaraj, M.D.

  • Internal Medicine Physician
  • Cumming, GA
National Provider Identifier
1588690879
Registry record updated Feb 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
058633 Issued in GA
Practice address
4415 Front Nine Dr Ste 600
Cumming, GA 30041-6239
Phone
(770) 744-7688
Fax
(770) 406-1058
NPI assigned
Jun 25, 2006
Last updated
Feb 11, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 11, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 058633 GA Primary

Addresses

Primary practice location

4415 Front Nine Dr Ste 600
Cumming, GA 30041-6239

Mailing address

4415 Front Nine Dr Ste 600
Cumming, GA 30041-6239
Phone (678) 456-8463

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080814000144 GA Practitioner - Internal MedicinePractitioner - Emergency Medicine 0042213126 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Blackpool LLCGroup PAC ID 2163667643, 3 clinicians

Practice addresses (Care Compare)

4415 Front Nine Dr
Suite 600
Cumming, GA 30041-6239
Phone (678) 456-8463

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
95.17 of 100Reported as group
Quality
99.39
Promoting interoperability
100
Improvement activities
40
Cost
51.17

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Blackpool LLC Internal Medicine CurrentSince Jan 21, 2013 Accepting new patients
Cherokee Center for Nursing and Healing LLC Past Accepting new patients
Roswell Center for Nursing and Healing LLC Past Accepting new patients
Pruitthealth - Fairburn, LLC Past Accepting new patients
Roswell Cypress LLC Past Accepting new patients
Pruitthealth - Christian City, LLC Past Accepting new patients
Glenwood Health Center by Harborview, LLC Past Accepting new patients
Lenora Church Road Property - SNF, LLC Past Accepting new patients
Chestnut Ridge Cypress LLC Past Accepting new patients

Locations

4415 Front Nine Dr
Ste 600
Cumming, GA 30041
Phone (678) 456-8463

5675 Jimmy Carter Blvd
Ste K
Norcross, GA 30071
Phone (770) 744-7688

2795 Main St W
Ste 21
Snellville, GA 30078
Phone (513) 218-3468

Interoperability endpoints

  • Direct secure messaging: vrangaraj123310@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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 11

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": "1151193600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676073600000",
    "number": "1588690879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4415 FRONT NINE DR STE 600",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "300416239",
            "telephone_number": "678-456-8463",
            "fax_number": "770-406-1058"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4415 FRONT NINE DR STE 600",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "300416239",
            "telephone_number": "770-744-7688",
            "fax_number": "770-406-1058"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RANGARAJ",
        "first_name": "VENKATAPPA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-25",
        "last_updated": "2023-02-11",
        "certification_date": "2023-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "058633",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cumming, GA

Sources for this page

Verify at the official NPI Registry.