Individual provider Active NPI

Sudheer Balakrishnan, M.D.

  • Diagnostic Radiology Physician
  • Atlanta, GA
National Provider Identifier
1770803983
Registry record updated Jul 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
92704 Issued in GA
Practice address
80 Jesse Hill Jr Dr SE FL 3
Atlanta, GA 30303-3050
Phone
(404) 616-1000
NPI assigned
Jun 10, 2010
Last updated
Jul 26, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 26, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X 0116022352 VA
Diagnostic Radiology Physician 2085R0202X 92704 GA Primary

Addresses

Primary practice location

80 Jesse Hill Jr Dr SE FL 3
Atlanta, GA 30303-3050

Mailing address

693 Peachtree St NE Apt 23D
Atlanta, GA 30308-4149
Phone (301) 787-2185

Other practice location 1

1500 San Pablo St
2nd Floor
Los Angeles, CA 90033-5313
Phone (323) 442-8541

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, 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
I20160615002130 CA Practitioner - Diagnostic Radiology 5698999712 Reassigns benefits to 2 organizations
I20220806000203 GA Practitioner - Diagnostic Radiology 5698999712 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
92704GAMDDiagnostic Radiology Physician
0116022352VAMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Emory Medical Care Foundation Inc Current Accepting new patients
County of Los Angeles Auditor Controller CurrentSince Jun 1, 2016 Accepting new patients
Emory Medical Care Foundation Inc Diagnostic Radiology CurrentSince Aug 1, 2022 Accepting new patients
County of Los Angeles CurrentSince Jun 1, 2016 Accepting new patients
The Emory Clinic Inc Diagnostic Radiology CurrentSince Aug 1, 2022 Accepting new patients
Usc Care Medical Group, Inc CurrentSince Jun 1, 2016 Accepting new patients
County of Los Angeles Current Accepting new patients
Usc Care Medical Group, Inc Diagnostic Radiology CurrentSince Jun 1, 2016 Accepting new patients

Locations

1500 San Pablo St
Fl 2
Los Angeles, CA 90033
Phone (323) 442-8541

1520 San Pablo St
Los Angeles, CA 90033
Phone (323) 442-5860

14445 Olive View Dr
Sylmar, CA 91342
Phone (881) 836-4303

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

2201 Henderson Mill Rd NE
Ste 160
Atlanta, GA 30345
Phone (404) 251-2193

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

80 Jesse Hill Jr Dr SE
Fl 3
Atlanta, GA 30303
Phone (404) 778-1550

Organizations & group practices 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1276128000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658793600000",
    "number": "1770803983",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "693 PEACHTREE ST NE APT 23D",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303084149",
            "telephone_number": "301-787-2185"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "80 JESSE HILL JR DR SE FL 3",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303033050",
            "telephone_number": "404-616-1000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1500 San Pablo St",
            "address_2": "2nd Floor",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900335313",
            "country_code": "US",
            "telephone_number": "323-442-8541",
            "fax_number": "323-442-8755",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BALAKRISHNAN",
        "first_name": "SUDHEER",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-06-10",
        "last_updated": "2022-07-26",
        "certification_date": "2022-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "VA",
            "license": "0116022352",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "GA",
            "license": "92704",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.