Individual provider Active NPI

Kenneth Myron Braunstein, M.D.

  • Hematology (Internal Medicine) Physician
  • Atlanta, GA
National Provider Identifier
1619064615
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology (Internal Medicine) PhysicianTaxonomy code 207RH0000X
License
29405 Issued in GA
Practice address
5667 Peachtree Dunwoody Rd NE
Suite 290
Atlanta, GA 30342-1725
Phone
(404) 255-1664
Fax
(404) 843-8987
NPI assigned
Oct 10, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology (Internal Medicine) Physician 207RH0000X 29405 GA Primary

Addresses

Primary practice location

5667 Peachtree Dunwoody Rd NE
Suite 290
Atlanta, GA 30342-1725

Mailing address

5667 Peachtree Dunwoody Rd NE
Suite 290
Atlanta, GA 30342-1725
Phone (404) 255-1664

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
I20060504000294 GA Practitioner - Internal MedicinePractitioner - Hematology/Oncology 1254341274 Reassigns benefits to 1 organization
Practice locations: Atlanta, GA

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Hematology/Oncology
Education
Medical University of South Carolina College of Medicine, 1976
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

5667 Peachtree Dunwoody Rd
Suite 294
Atlanta, GA 30342-1716
Phone (404) 255-1664

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
29405GAMDHematology (Internal Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Southeast Permanente Medical Group Current Accepting new patients

Locations

3495 Piedmont Rd NE
Bldg 9
Atlanta, GA 30305
Phone (404) 364-7000

Organizations & group practices 1

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": "1160438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1619064615",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5667 PEACHTREE DUNWOODY RD NE",
            "address_2": "SUITE 290",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303421725",
            "telephone_number": "404-255-1664",
            "fax_number": "404-843-8987"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5667 PEACHTREE DUNWOODY RD NE",
            "address_2": "SUITE 290",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303421725",
            "telephone_number": "404-255-1664",
            "fax_number": "404-843-8987"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRAUNSTEIN",
        "first_name": "KENNETH",
        "middle_name": "MYRON",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology",
            "state": "GA",
            "license": "29405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.