Individual provider Active NPI

Ajay Kamireddi, MD

  • Diagnostic Radiology Physician
  • Atlanta, GA
National Provider Identifier
1720266695
Registry record updated Jun 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
80029 Issued in GA
Practice address
1365C Clifton Rd NE Ste C1104
Atlanta, GA 30322
Phone
(404) 778-4446
NPI assigned
Feb 4, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 26, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 002758 GA
Diagnostic Radiology Physician 2085R0202X 264154-1 NY
Diagnostic Radiology Physician 2085R0202X 80029 GA Primary

Addresses

Primary practice location

1365C Clifton Rd NE Ste C1104
Atlanta, GA 30322

Mailing address

1365C Clifton Rd NE Ste C1104
Atlanta, GA 30322-1013
Phone (404) 778-4446

Other practice location 1

150 East Sunrise Highway
Lindenhurst, NY 11757
Phone (631) 225-7200

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
I20180918001387 GA Practitioner - Diagnostic Radiology 9234394412 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Duke University School of Medicine, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Emory Clinic IncGroup PAC ID 8820901408, 3,507 clinicians

Practice addresses (Care Compare)

1365 Clifton Rd NE
Atlanta, GA 30322-1013
Phone (404) 778-7525

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.24 of 100Reported as group
Quality
73.72
Promoting interoperability
100
Improvement activities
40
Cost
75.22

Merit-based Incentive Payment System (MIPS)

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. 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

State licenses

LicenseStateTypeSpecialty
002758GAMDDiagnostic Radiology Physician
80029GAMDDiagnostic Radiology Physician
264154-1NYMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Emory Medical Care Foundation Inc Diagnostic Radiology CurrentSince Jul 1, 2018 Accepting new patients
The Emory Clinic Inc Diagnostic Radiology CurrentSince Jul 1, 2018 Accepting new patients
Emory Medical Care Foundation Inc CurrentSince Jul 1, 2018 Accepting new patients

Locations

1365 Clifton Rd NE
Atlanta, GA 30322
Phone (404) 778-7525

1365 Clifton Rd NE
Ste C1104
Atlanta, GA 30322
Phone (404) 778-4446

80 Jesse Hill Jr Dr SE
Atlanta, GA 30303
Phone (404) 616-4370

101 W Ponce de Leon Ave
Decatur, GA 30030
Phone (404) 778-4889

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 5

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": "1202083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687737600000",
    "number": "1720266695",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1365C CLIFTON RD NE STE C1104",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303221013",
            "telephone_number": "404-778-4446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1365C CLIFTON RD NE STE C1104",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "30322",
            "telephone_number": "404-778-4446"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "150 East Sunrise Highway",
            "address_purpose": "LOCATION",
            "city": "Lindenhurst",
            "state": "NY",
            "postal_code": "11757",
            "country_code": "US",
            "telephone_number": "631-225-7200",
            "fax_number": "631-870-8732",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KAMIREDDI",
        "first_name": "AJAY",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-02-04",
        "last_updated": "2023-06-26",
        "certification_date": "2023-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "GA",
            "license": "002758",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NY",
            "license": "264154-1",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "GA",
            "license": "80029",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.