Individual provider Active NPI

Vinod Jeyaretnam, DO

  • Internal Medicine Physician
  • Athens, GA
National Provider Identifier
1609526862
Registry record updated Jun 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
103627 Issued in GA
Practice address
1500 Oglethorpe Ave Ste 200C
Athens, GA 30606-2165
Phone
(706) 389-3875
Fax
(706) 389-3876
NPI assigned
Mar 28, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2025

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 103627 GA Primary

Addresses

Primary practice location

1500 Oglethorpe Ave Ste 200C
Athens, GA 30606-2165

Mailing address

PO Box 48089
Athens, GA 30604-8089
Phone (706) 389-3740

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address vjeyaretnam2017486@direct.trinity-health.org Direct

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
I20250714004368 GA Practitioner - Internal Medicine 9335520014 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
West Virginia University School of Medicine, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St. Mary'S Medical Group, Inc.Group PAC ID 7113098393, 118 clinicians

Practice addresses (Care Compare)

1230 Baxter St
Athens, GA 30606-3712
Phone (706) 389-3000

1500 Oglethorpe Ave
Suite 200C
Athens, GA 30606-2165
Phone (706) 389-3875

Hospital & facility affiliations

  • St Mary'S Hospital Hospital, Athens, GA, CCN 110006

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
St Mary'S Medical Group, Inc Current Accepting new patients
St. Mary'S Medical Group, Inc. CurrentSince Jul 1, 2025 Accepting new patients
Hospital Physician Services - Southeast Professional Corporation CurrentSince Aug 1, 2025 Accepting new patients
St. Mary'S Medical Group, Inc. CurrentSince Jul 1, 2025 Accepting new patients
St. Mary'S Medical Group, Inc. Internal Medicine Past Accepting new patients
St. Mary'S Hospital, Inc. Past Accepting new patients

Locations

1500 Oglethorpe Ave
Ste 200C
Athens, GA 30606
Phone (706) 389-3875

1230 Baxter St
Athens, GA 30606
Phone (706) 364-3100

1500 Oglethorpe Ave
Athens, GA 30606
Phone (706) 389-2273

740 Prince Ave
Ste 2
Athens, GA 30606
Phone (706) 548-5488

501 Redmond Rd NW
Rome, GA 30165
Phone (706) 291-0291

Interoperability endpoints

  • Direct secure messaging: vjeyaretnam2017486@direct.trinity-health.org
  • FHIR API: https://api.platform.athenahealth.com/7598/brand/1/csg/1/fhir/r4

Organizations & group practices 6

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.

Hospital & facility affiliations 1

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": "1648425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749772800000",
    "number": "1609526862",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 48089",
            "city": "ATHENS",
            "state": "GA",
            "postal_code": "306048089",
            "telephone_number": "706-389-3740",
            "fax_number": "706-389-3951"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 OGLETHORPE AVE STE 200C",
            "city": "ATHENS",
            "state": "GA",
            "postal_code": "306062165",
            "telephone_number": "706-389-3875",
            "fax_number": "706-389-3876"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JEYARETNAM",
        "first_name": "VINOD",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-03-28",
        "last_updated": "2025-06-13",
        "certification_date": "2025-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "103627",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "vjeyaretnam2017486@direct.trinity-health.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1500 Oglethorpe Ave Ste 200C",
            "city": "Athens",
            "state": "GA",
            "country_code": "US",
            "postal_code": "306062165",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Athens, GA

Sources for this page

Verify at the official NPI Registry.