Individual provider Active NPI

Jayaraman Venkatesan, MD

  • Interventional Cardiology Physician
  • Conyers, GA
National Provider Identifier
1679871180
Registry record updated Aug 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Cardiology PhysicianTaxonomy code 207RI0011X
License
91781 Issued in GA
Practice address
1412 Milstead Ave NE Ste 100
Conyers, GA 30012-3877
Phone
(770) 483-9330
NPI assigned
Mar 8, 2011
Last updated
Aug 25, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 0101256488 VA
Interventional Cardiology Physician 207RI0011X 0101256488 VA
Interventional Cardiology Physician 207RI0011X 91781 GA Primary

Addresses

Primary practice location

1412 Milstead Ave NE Ste 100
Conyers, GA 30012-3877

Mailing address

1412 Milstead Ave NE Ste 100
Conyers, GA 30012-3877
Phone (770) 483-9330

Other practice location 1

1030 Hillpoint Blvd N
Suffolk, VA 23434-8470
Phone (757) 539-0444

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, GA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20141119002637 VA Practitioner - Interventional CardiologyPractitioner - Cardiovascular Disease (Cardiology)Practitioner - Other (Physician) 8921132655 Reassigns benefits to 1 organization
I20221107002233 GA Practitioner - Interventional Cardiology 8921132655 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Interventional Cardiology
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Piedmont Cardiology of Atlanta, LLCGroup PAC ID 0345321691, 478 clinicians

Practice addresses (Care Compare)

1412 Milstead Ave NE
Conyers, GA 30012-3877
Phone (770) 918-3000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
91.62 of 100Reported as apm
Quality
83.25
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting17

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Bon Secours Medical Group Hampton Roads Specialty Care LLC CurrentSince Jan 1, 2020 Accepting new patients
Piedmont Cardiology of Atlanta, LLC Cardiovascular Disease CurrentSince Jul 25, 2022 Accepting new patients
Bon Secours Medical Group Hampton Roads Specialty Care LLC Cardiovascular Disease CurrentSince Jan 1, 2020 Accepting new patients
Cardiovascular Institute of the South, LLC Cardiovascular Disease Past Accepting new patients

Locations

1412 Milstead Ave NE
Conyers, GA 30012
Phone (770) 918-3000

1412 Milstead Ave NE
Ste 100
Conyers, GA 30012
Phone (770) 483-9330

2151 W Spring St
Ste B220
Monroe, GA 30655
Phone (770) 267-1895

150 Kingsley Ln
Norfolk, VA 23505
Phone (757) 464-6944

3636 High St
Portsmouth, VA 23707
Phone (757) 398-2200

8580 Magellan Pkwy
Richmond, VA 23227
Phone (804) 627-5462

1030 Hillpoint Blvd N
Suffolk, VA 23434
Phone (757) 539-0444

5838 Harbour View Blvd
Ste 270
Suffolk, VA 23435
Phone (757) 541-1050

7007 Harbour View Blvd
Ste 108
Suffolk, VA 23435
Phone (757) 215-2784

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

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": "1299542400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661385600000",
    "number": "1679871180",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1412 MILSTEAD AVE NE STE 100",
            "city": "CONYERS",
            "state": "GA",
            "postal_code": "300123877",
            "telephone_number": "770-483-9330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1412 MILSTEAD AVE NE STE 100",
            "city": "CONYERS",
            "state": "GA",
            "postal_code": "300123877",
            "telephone_number": "770-483-9330"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1030 Hillpoint Blvd N",
            "address_purpose": "LOCATION",
            "city": "Suffolk",
            "state": "VA",
            "postal_code": "234348470",
            "country_code": "US",
            "telephone_number": "757-539-0444",
            "fax_number": "757-539-4824",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VENKATESAN",
        "first_name": "JAYARAMAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-03-08",
        "last_updated": "2022-08-25",
        "certification_date": "2022-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "VA",
            "license": "0101256488",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "VA",
            "license": "0101256488",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "GA",
            "license": "91781",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Conyers, GA

Sources for this page

Verify at the official NPI Registry.