Ruchir Agrawal
Individual provider Active NPI Allergy Physician · Peachtree City, GA
NPI 1831285618 · NPPES record last updated Jul 21, 2022
Key facts
- NPI
- 1831285618
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Allergy Physician 207KA0200X
- License
- 43561 (WI)
- Practice address
- 115 Genevieve CT
Peachtree City, GA 30269 - Phone
- (678) 400-6650
- Fax
- (678) 669-2401
- NPI assigned
- Oct 5, 2006
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare Care Compare profile
- Specialty
- Allergy/Immunology
- Education
- Other, 1994
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Allergy Sinus and Cough Center of Georgia, Inc
Practice addresses (Care Compare)
115 Genevieve CT
Peachtree City, GA 30269-4803
Phone (678) 400-6650
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: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20130723000516 | GA | Practitioner - Allergy/Immunology |
0749203164 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Allergy Sinus and Cough Center of Georgia, Inc | Current |
Accepting new patients | |
| City of Hope Medical Group of Georgia LLC | Current |
Accepting new patients |
Locations
600 Celebrate Life Pkwy
Newnan, GA 30265
Phone (404) 844-8334
115 Oak Hill Blvd
#100
Newnan, GA 30265
Phone (678) 400-6650
4000 Shakerag Hl
Ste 300
Peachtree City, GA 30269
Phone (262) 327-0704
115 Genevieve Ct
Peachtree Cty, GA 30269
Phone (678) 400-6650
62742 Collections Ctr Dr
Chicago, IL 60693
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 43561 | WI | |
| Allergy Physician | 207KA0200X | 43561 | WI | Yes |
Addresses
Primary practice location
115 Genevieve CT
Peachtree City, GA 30269
Mailing address
115 Genevieve CT
Peachtree City, GA 30269
Phone (678) 400-6650
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 003130521D&E | Medicaid | GA | |
| 34123200 | Medicaid | WI |
Other providers in Peachtree City, GA
- Aesthetic Restorative Dentistry, P. C.
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- Affordable Dental
- Ageless Center of Regenerative & Wellness Medicine
- Ageless Women'S Health Ga LLC
- Andrew C Agwunobi
- Jude Agyeman
- Zouhal Ahmadi
- Naddia Ahmed
- Julia Akins
All providers in Peachtree City, GA · Allergy 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 Jul 21, 2022. 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.