Vikram Gautam Pankaj Raje, DO
Individual provider Active NPI Advanced Heart Failure and Transplant Cardiology Physician · Gainesville, GA
NPI 1649563255 · NPPES record last updated Dec 7, 2020
Key facts
- NPI
- 1649563255
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Advanced Heart Failure and Transplant Cardiology Physician 207RA0001X
- License
- 85219 (GA)
- Practice address
- 743 Spring St NE
Gainesville, GA 30501-3715 - Phone
- (770) 534-2020
- Fax
- (770) 534-8025
- NPI assigned
- May 16, 2011
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 6
Hospital & facility affiliations 5
Medicare Care Compare profile
- Specialty
- Advanced Heart Failure and Transplant Cardiology
- Education
- Ohio State University College of Medicine, 2008
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Legacy Heart Care of Gainesville, LLC
Georgia Heart Institute LLC
Practice addresses (Care Compare)
1650 Jesse Jewell Pkwy NE
Gainesville, GA 30501-2547
Phone (770) 935-1111
743 Spring St NE
Gainesville, GA 30501-3715
Phone (770) 534-2020
Hospital & facility affiliations
- Northeast Georgia Medical Center, Inc
- Northeast Georgia Medical Center Lumpkin
- Northeast Georgia Medical Center Habersham
- NGMC Barrow, LLC
- Union General Hospital
Merit-based Incentive Payment System (MIPS)
- Final score
- 88.46 of 100
- Quality
- 85.33
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 76.19
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Coronary angioplasty and stenting | 14 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in GA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20200413003141 | GA | Practitioner - Advanced Heart Failure and Transplant Cardiology | 3274774625 | Reassigns benefits to 4 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 85219 | GA | MD | Interventional Cardiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Northeast Georgia Medical Center, Inc. | Current | Accepting new patients | |
| Georgia Heart Institute LLC | Advanced Heart Failure and Transplant Cardiology | Current |
Accepting new patients |
| Northeast Georgia Heart Center | Current | Accepting new patients | |
| Northeast Georgia Medical Center, Inc. | Current |
Accepting new patients | |
| NGMC Lumpkin, LLC | Current |
Accepting new patients |
Locations
1400 River Pl
Braselton, GA 30517
Phone (770) 219-6000
227 Mountain Dr
Dahlonega, GA 30533
Phone (706) 864-6136
743 Spring St NE
Gainesville, GA 30501
Phone (770) 219-5915
200 S Enota Dr NE
Ste 200
Gainesville, GA 30501
Phone (770) 534-0991
Interoperability endpoints
- vraje106127@nghs.gadirect.net
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Interventional Cardiology Physician | 207RI0011X | 85219 | GA | |
| Advanced Heart Failure and Transplant Cardiology Physician | 207RA0001X | 85219 | GA | Yes |
Addresses
Primary practice location
743 Spring St NE
Gainesville, GA 30501-3715
Mailing address
PO Box 742616
Atlanta, GA 30374-2616
Phone (770) 219-8420
Other practice location 1
417 N 11th St
Im: Resident Acc Clinic
Richmond, VA 23298-5002
Phone (804) 828-1941
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | vraje106127@nghs.gadirect.net | Direct |
Other providers in Gainesville, GA
- Jessica Lori Radchuk
- Sri Jegan Radhakrishnan
- Cameron Ragland
- Heather Perona Ragland
- Matthew J Ragsdale
- Ralston Rehabilitation, Inc.
- Lisa S. Ralston
- Vijaya Sivalingam Ramalingam
- Tonya R Ramey
- Hillary Murphy Ramos
All providers in Gainesville, GA · Advanced Heart Failure and Transplant Cardiology Physician in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 7, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.