Individual provider Active NPI

Malathi Venkatesan, MD

  • Internal Medicine Physician
  • Duluth, GA
National Provider Identifier
1861403057
Registry record updated Aug 29, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD67038 Issued in GA
Practice address
1845 Satellite Blvd
Suite 500
Duluth, GA 30097-5256
Phone
(404) 778-5220
Fax
(404) 778-6451
NPI assigned
Aug 11, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD67038 GA Primary

Addresses

Primary practice location

1845 Satellite Blvd
Suite 500
Duluth, GA 30097-5256

Mailing address

1845 Satellite Blvd
Suite 500
Duluth, GA 30097-5256
Phone (404) 778-5220

Other identifiers 10

IdentifierTypeStateIssuer
001518398OtherHIGHMARK
1536140OtherGATEWAY
1784451OtherUNITED HEALTHCARE
6709237003OtherCIGNA
3359545OtherAETNA
01585449MedicaidPA
043771728OtherHEALTH AMERICA
145688OtherUNISON
200195OtherUPMC
14517OtherELDER HEALTH

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
I20120117000276 GA Practitioner - Internal Medicine 8921146986 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Esop Rehabilitation LLCGroup PAC ID 9739305749, shared by 9 NPIs, 224 clinicians
Emory Specialty Associates, LLCGroup PAC ID 3476559782, 706 clinicians

Practice addresses (Care Compare)

1699 Hwy 124 N
Snellville, GA 30078-7921
Phone (678) 218-6702

300 Tower Rd NE
Suite 150
Marietta, GA 30060-9405
Phone (678) 594-0070

Hospital & facility affiliations

  • Central Home Health Care, an Amedisys Company Home health agency, Tucker, GA, CCN 117026
  • Emory Johns Creek Hospital Hospital, Johns Creek, GA, CCN 110230
  • Northside Hospital Gwinnett Hospital, Lawrenceville, GA, CCN 110087
  • Emory University Hospital Midtown Hospital, Atlanta, GA, CCN 110078
  • Saint Joseph'S Hospital of Atlanta, Inc Hospital, Atlanta, GA, CCN 110082
  • Emory University Hospital Hospital, Atlanta, GA, CCN 110010

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD67038GAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Emory Clinic Inc Internal Medicine CurrentSince Jan 1, 2012 Accepting new patients
Emory Specialty Associates, LLC Internal Medicine CurrentSince Apr 23, 2014 Accepting new patients

Locations

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

1821 Clifton Rd NE
Atlanta, GA 30329
Phone (404) 728-6812

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

1845 Satellite Blvd
Ste 500
Duluth, GA 30097
Phone (404) 778-5220

300 Tower Rd NE
Ste 150
Marietta, GA 30060
Phone (678) 594-0070

Interoperability endpoints

  • Direct secure messaging: mvenkatesan56763@direct.emory.org

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 and National Provider Directory roles.

Hospital & facility affiliations 7

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": "1155254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1409270400000",
    "number": "1861403057",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1845 SATELLITE BLVD",
            "address_2": "SUITE 500",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "300975256",
            "telephone_number": "404-778-5220",
            "fax_number": "404-778-6451"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1845 SATELLITE BLVD",
            "address_2": "SUITE 500",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "300975256",
            "telephone_number": "404-778-5220",
            "fax_number": "404-778-6451"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VENKATESAN",
        "first_name": "MALATHI",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-11",
        "last_updated": "2014-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "MD67038",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK",
            "identifier": "001518398",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GATEWAY",
            "identifier": "1536140",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "1784451",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "6709237003",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "3359545",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01585449",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH AMERICA",
            "identifier": "043771728",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNISON",
            "identifier": "145688",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UPMC",
            "identifier": "200195",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ELDER HEALTH",
            "identifier": "14517",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Duluth, GA

Sources for this page

Verify at the official NPI Registry.