David Romesh Persaud, MD

Primary specialty

Geriatric Medicine (Family Medicine) PhysicianTaxonomy code 207QG0300X

License

70703 Issued in GA

Practice address

772 Maddox Dr
Ste. 122
East Ellijay, GA 30540-8196

Phone

(706) 635-6898

Fax

(706) 635-6888

NPI assigned

May 24, 2007

Last updated

Jan 28, 2019By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in FL

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Gulfview Medical Institute PLLC

  • Family Medicine Physician
  • Port Charlotte, FL
  • NPI 1851680789
  Medicare reassignment NPD

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

{
    "created_epoch": "1179964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548633600000",
    "number": "1609087527",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "165 BLUE RIDGE OVERLOOK",
            "city": "BLUE RIDGE",
            "state": "GA",
            "postal_code": "305134431",
            "telephone_number": "706-946-5600",
            "fax_number": "706-374-7628"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "772 MADDOX DR",
            "address_2": "STE. 122",
            "city": "EAST ELLIJAY",
            "state": "GA",
            "postal_code": "305408196",
            "telephone_number": "706-635-6898",
            "fax_number": "706-635-6888"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "134 Ansley Dr Ste 700",
            "address_purpose": "LOCATION",
            "city": "Dahlonega",
            "state": "GA",
            "postal_code": "305331641",
            "country_code": "US",
            "telephone_number": "706-946-5602",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PERSAUD",
        "first_name": "DAVID",
        "middle_name": "ROMESH",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-24",
        "last_updated": "2019-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QG0300X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": "GA",
            "license": "70703",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003143127A",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "202I087630",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1035769",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Thomas A Nguyen, DO
• Shelby Lee Nix, OT
• North Georgia Physical Therapy
• Lesa Parker, MS, ARPN, NP-C
• Milton Lynn Perry, MSCE, DMIN
• Tracie Glass Pospisil, SLP
• Professional Eye Associate
• Anne Rathbone
• Jeffrey Scott Rennie, PTA
• Gary L Rogers, PHD

• Geriatric Medicine (Family Medicine) Physician in East Ellijay, GA
• Providers in East Ellijay, GA by specialty
• Geriatric Medicine (Family Medicine) Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2019; 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.

Verify at the official NPI Registry.