Individual provider Active NPI

Sri Krishna Mukkamala, MD

  • Hospitalist Physician
  • Cumming, GA
National Provider Identifier
1710184148
Registry record updated May 5, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
069313 Issued in GA
Practice address
1200 Northside Forsyth Dr
Cumming, GA 30041-7659
Phone
(770) 844-3200
Fax
(404) 851-6325
NPI assigned
Jun 29, 2007
Last updated
May 5, 2017By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 5, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 250427 NY
Hospitalist Physician 208M00000X 069313 GA Primary

Addresses

Primary practice location

1200 Northside Forsyth Dr
Cumming, GA 30041-7659

Mailing address

1200 Northside Forsyth Dr
Cumming, GA 30041-7659
Phone (770) 844-3200

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
I20130415000047 GA Practitioner - Ophthalmology 6608048384 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Georgia Retina, PCGroup PAC ID 1254328248, 23 clinicians

Practice addresses (Care Compare)

1100 Johnson Fy Rd NE
BLDG 2, Suite 593
Sandy Springs, GA 30342-1733
Phone (404) 255-9096

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94.51 of 100Reported as apm
Quality
80.61
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Georgia Retina, PC Ophthalmology CurrentSince Jun 10, 2013 Accepting new patients
Piedmont Medical Care Corporation PastSince Jun 10, 2013 Accepting new patients

Locations

1255 Friendship Rd
Ste 160
Braselton, GA 30517
Phone (678) 528-1101

100 Market Place Blvd
Ste 304
Cartersville, GA 30121
Phone (470) 274-2030

1835 Savoy Dr
Ste 100
Chamblee, GA 30341
Phone (678) 298-9484

990 Sanders Rd
#100
Cumming, GA 30041
Phone (678) 679-4830

6095 Professional Pkwy
Ste B102
Douglasville, GA 30134
Phone (678) 303-0136

1488 Jesse Jewell Pkwy SE
Ste 200
Gainesville, GA 30501
Phone (404) 875-9011

575 Professional Dr
Ste 330
Lawrenceville, GA 30046
Phone (404) 255-9096

6055 Lakeside Commons Dr
Ste 310
Macon, GA 31210
Phone (478) 238-9733

833 Campbell Hill St NW
Ste 300
Marietta, GA 30060
Phone (770) 218-1888

403 Westpark Ct
Ste 110
Peachtree Cty, GA 30269
Phone (770) 486-1633

1100 Johnson Fy Rd NE
Ste 593
Sandy Springs, GA 30342
Phone (404) 255-9096

175 Country Club Dr
Bldg 300D
Stockbridge, GA 30281
Phone (678) 284-4040

350 Country Club Dr
Ste A
Stockbridge, GA 30281
Phone (770) 692-4000

1462 Montreal Rd
Ste 412
Tucker, GA 30084
Phone (770) 396-2496

500 Ross St
Pittsburgh, PA 15262
Phone (844) 362-6808

Organizations & group practices 2

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 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": "1183075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1493942400000",
    "number": "1710184148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 NORTHSIDE FORSYTH DR",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "300417659",
            "telephone_number": "770-844-3200",
            "fax_number": "404-851-6325"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 NORTHSIDE FORSYTH DR",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "300417659",
            "telephone_number": "770-844-3200",
            "fax_number": "404-851-6325"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUKKAMALA",
        "first_name": "SRI KRISHNA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-29",
        "last_updated": "2017-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "NY",
            "license": "250427",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "GA",
            "license": "069313",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cumming, GA

Sources for this page

Verify at the official NPI Registry.