Individual provider Active NPI

Sangeeth Rao Dubbireddi, MD

  • Critical Care Medicine (Internal Medicine) Physician
  • Marietta, GA
National Provider Identifier
1629356332
Registry record updated Aug 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Care Medicine (Internal Medicine) PhysicianTaxonomy code 207RC0200X
License
91871 Issued in GA
Practice address
400 Tower Rd NE Ste 200
Marietta, GA 30060-9412
Phone
(770) 422-1372
Fax
(770) 999-2488
NPI assigned
Jul 29, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine (Internal Medicine) Physician 207RC0200X 108915 MN
Critical Care Medicine (Internal Medicine) Physician 207RC0200X 91871 GA Primary

Addresses

Primary practice location

400 Tower Rd NE Ste 200
Marietta, GA 30060-9412

Mailing address

400 Tower Rd NE Ste 200
Marietta, GA 30060-9412
Phone (770) 422-1372

Other practice location 1

400 E 3rd St
Essentia Health Duluth Clinic
Duluth, MN 55805-1951
Phone (218) 786-8364

Other practice location 2

1801 N Senate Ave Ste 2000
Indianapolis, IN 46202
Phone (317) 963-0174

Other identifiers 1

IdentifierTypeStateIssuer
01080554AOtherININDIANA MEDICAL LICENSE

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address sdubbireddi491259@directwellstar.org Health Information Exchange (HIE)

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
I20220620001330 GA Practitioner - Critical Care (Intensivists) 8426289919 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Critical Care (Intensivists)
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wellstar Medical Group LLCGroup PAC ID 6709065402, 3,059 clinicians

Practice addresses (Care Compare)

3950 Austell Rd
Austell, GA 30106-1121
Phone (770) 732-4022

5150 Stilesboro N W Rd
Suite 220
Kennesaw, GA 30152-7742
Phone (770) 424-8222

625 Church Nest
Marietta, GA 30060-1101
Phone (770) 422-2004

677 Church Nest
Marietta, GA 30060-1101

677 Church St NE
Suite 100P
Marietta, GA 30060-1101
Phone (470) 793-8585

Hospital & facility affiliations

  • Wellstar Kennestone Regional Medical Center Hospital, Marietta, GA, CCN 110035
  • Wellstar Cobb Medical Center Hospital, Austell, GA, CCN 110143

Merit-based Incentive Payment System (MIPS)

Final score
93.93 of 100Reported as apm
Quality
82.14
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Wellstar Medical Group, LLC CurrentSince Jul 1, 2022 Accepting new patients
Wellstar Medical Group, LLC CurrentSince Jul 1, 2022 Accepting new patients
Wellstar Medical Group, LLC Current Accepting new patients

Locations

5150 Stilesboro Rd NW
Ste 220
Kennesaw, GA 30152
Phone (770) 424-8222

400 Tower Rd NE
Ste 200
Marietta, GA 30060
Phone (770) 514-7550

805 Sandy Plains Rd
Marietta, GA 30066
Phone (770) 792-1616

Organizations & group practices 3

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 2

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": "1311897600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660867200000",
    "number": "1629356332",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 TOWER RD NE STE 200",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300609412",
            "telephone_number": "770-422-1372",
            "fax_number": "770-999-2488"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 TOWER RD NE STE 200",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300609412",
            "telephone_number": "770-422-1372",
            "fax_number": "770-999-2488"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "400 E 3rd St",
            "address_2": "Essentia Health Duluth Clinic",
            "address_purpose": "LOCATION",
            "city": "Duluth",
            "state": "MN",
            "postal_code": "558051951",
            "country_code": "US",
            "telephone_number": "218-786-8364",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1801 N Senate Ave Ste 2000",
            "address_purpose": "LOCATION",
            "city": "Indianapolis",
            "state": "IN",
            "postal_code": "46202",
            "country_code": "US",
            "telephone_number": "317-963-0174",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DUBBIREDDI",
        "first_name": "SANGEETH",
        "middle_name": "RAO",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-07-29",
        "last_updated": "2022-08-19",
        "certification_date": "2022-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "MN",
            "license": "108915",
            "primary": false
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "GA",
            "license": "91871",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIANA MEDICAL LICENSE",
            "identifier": "01080554A",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sdubbireddi491259@directwellstar.org",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "400 Tower Rd NE Ste 200",
            "city": "Marietta",
            "state": "GA",
            "country_code": "US",
            "postal_code": "300609412",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Marietta, GA

Sources for this page

Verify at the official NPI Registry.