Srinivasa Kumar Gorjala, M.D., F.A.C.S.

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

043378 Issued in GA

Practice address

6135 Barfield Rd Ste 150
Sandy Springs, GA 30328-4309

Phone

(404) 250-6691

Fax

(404) 250-8847

NPI assigned

Oct 7, 2005

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 1

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

General Surgery

Education

Other, 1992

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Northside Surgical Professional Services LLCGroup PAC ID 8628253424, 367 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Northside Hospital Hospital, Atlanta, GA, CCN 110161
• Northside Hospital Cherokee Hospital, Canton, GA, CCN 110008
• Northside Hospital Forsyth Hospital, Cumming, GA, CCN 110005
• Northside Hospital Gwinnett Hospital, Lawrenceville, GA, CCN 110087

Procedures performed for Medicare patients

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.

• Northside Surgical Professional Services LLC

  • Surgery Physician
  • Atlanta, GA
  • NPI 1356630990
  Medicare reassignment Care Compare group NPD
• Southern Regional Health System, Inc

  • General Acute Care Hospital
  • Riverdale, GA
  • NPI 1831190958
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Northside Hospital, Inc.

  • General Acute Care Hospital
  • Canton, GA
  • NPI 1225050396
  Care Compare affiliation
• Northside Hospital, Inc.

  • General Acute Care Hospital
  • Cumming, GA
  • NPI 1376574277
  Care Compare affiliation
• Northside Hospital, Inc.

  • General Acute Care Hospital
  • Atlanta, GA
  • NPI 1457396079
  Care Compare affiliation
• Northside Hospital, Inc.

  • General Acute Care Hospital
  • Lawrenceville, GA
  • NPI 1952340994
  Care Compare affiliation

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

{
    "created_epoch": "1128643200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643846400000",
    "number": "1639167299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6135 BARFIELD RD STE 150",
            "city": "SANDY SPRINGS",
            "state": "GA",
            "postal_code": "303284309",
            "telephone_number": "404-250-6691",
            "fax_number": "404-250-8847"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6135 BARFIELD RD STE 150",
            "city": "SANDY SPRINGS",
            "state": "GA",
            "postal_code": "303284309",
            "telephone_number": "404-250-6691",
            "fax_number": "404-250-8847"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3855 Pleasant Hill Rd Ste 330",
            "address_purpose": "LOCATION",
            "city": "Duluth",
            "state": "GA",
            "postal_code": "300968030",
            "country_code": "US",
            "telephone_number": "678-312-6200",
            "fax_number": "678-312-6012",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3215 McClure Bridge Rd",
            "address_purpose": "LOCATION",
            "city": "Duluth",
            "state": "GA",
            "postal_code": "300963223",
            "country_code": "US",
            "telephone_number": "678-312-6200",
            "fax_number": "678-312-6012",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GORJALA",
        "first_name": "SRINIVASA",
        "middle_name": "KUMAR",
        "name_prefix": "Dr.",
        "credential": "M.D., F.A.C.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-07",
        "last_updated": "2022-02-03",
        "certification_date": "2022-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "GA",
            "license": "043378",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00749625A",
            "state": "GA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "BIA@Northside.gwaydirect.com",
            "affiliation": "N",
            "endpointDescription": "Direct Messaging",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Direct Edge",
            "address_1": "6135 Barfield Rd",
            "address_2": "Ste 150",
            "city": "Sandy Springs",
            "state": "GA",
            "country_code": "US",
            "postal_code": "303284307",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Ryanne Gonzalez, BSN, RN
• David M Goodridge
• Donna Bowie Goodwin, D.C.
• Aaron Gordon
• Palacia Gordon
• Amber Gosa, COA
• Brielle Rebekah Gould, LCSW
• Geetika Goyal, FNP-C
• Jalessa Jonelle Graham-Hudgins, MD
• Grain of Sand Academy

• Surgery Physician in Sandy Springs, GA
• Providers in Sandy Springs, GA by specialty
• Surgery Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2022; 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.