Nagalakshmi Charitha Suryadevara, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

058515 Issued in GA

Practice address

1968 Peachtree Rd NW
Atlanta, GA 30309-1281

Phone

(404) 605-3248

NPI assigned

May 16, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 3

Electronic endpoints 1

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

Specialty

Family Practice

Education

Other, 1998

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Gwinnett Hospital System Gme, LLCGroup PAC ID 0648504894, 23 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Gwinnett Hospital System Gme, LLC

  • Family Medicine Physician
  • Lawrenceville, GA
  • NPI 1780076927
  Medicare reassignment Care Compare group NPD
• Gwinnett Physician Group, LLC

  • Internal Medicine Physician
  • Lawrenceville, GA
  • NPI 1578574661

  Family Medicine

  Medicare reassignment NPD
• Northside Urgent Care Holding, LLC

  • Urgent Care Clinic/Center
  • Atlanta, GA
  • NPI 1679962237
  Medicare reassignment NPD
• Northside Urgent Care

  • Family Medicine Physician
  • Marietta, GA
  • NPI 1518905108
  NPD
• Wellstar Medical Group, LLC

  • Internal Medicine Physician
  • Woodstock, GA
  • NPI 1548566185

  Family Medicine

  NPD (past)

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

{
    "created_epoch": "1179273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614297600000",
    "number": "1609083344",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "517 BROOKESHYRE CT",
            "city": "WOODSTOCK",
            "state": "GA",
            "postal_code": "301883199",
            "telephone_number": "770-592-3245"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1968 PEACHTREE RD NW",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303091281",
            "telephone_number": "404-605-3248"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SURYADEVARA",
        "first_name": "NAGALAKSHMI",
        "middle_name": "CHARITHA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-16",
        "last_updated": "2021-02-26",
        "certification_date": "2021-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QH0002X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Hospice and Palliative Medicine",
            "state": "GA",
            "license": "058515",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "058515",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "378304400D",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "378304400C",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "378304400F",
            "state": "GA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "NFMUC_Cumming@Northside.gwaydirect.com",
            "affiliation": "N",
            "endpointDescription": "Direct Messaging",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Direct Edge",
            "address_1": "1968 Peachtree Rd NW",
            "city": "Atlanta",
            "state": "GA",
            "country_code": "US",
            "postal_code": "303091281",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Aleksandr Surovets, PA
• Gensen M Surpris
• Kia-Symone Surrell, DMD
• Karen Survilas, FNP
• Survival 2 Victory, Inc.
• Raghuveer Suryadevara, MD
• Sindhura Suryadevara, M.D.
• Susan H Lee DMD LLC
• Susan Katrin PH.D., PC
• Susan M. Hay, Psy.D. PC

• Family Medicine Physician in Atlanta, GA
• Providers in Atlanta, GA by specialty
• Family Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2021; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.