NPIMap

Individual provider Active NPI

Naga V a Kommuri, MD

  • Cardiovascular Disease Physician
  • Braselton, GA
National Provider Identifier
1942476643
Registry record updated Dec 7, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
77489 Issued in GA
Practice address
1404 River PL Ste 501
Braselton, GA 30517-5600
Phone
(770) 534-2020
Fax
(770) 534-8025
NPI assigned
May 2, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 7, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 77489 GA Primary

Addresses

Primary practice location

1404 River PL Ste 501
Braselton, GA 30517-5600

Mailing address

PO Box 742616
Atlanta, GA 30374-2616
Phone (770) 219-8420

Other identifiers 1

IdentifierTypeStateIssuer
1942476643MedicaidMI

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address nkommuri106132@nghs.gadirect.net Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170823001279 GA Practitioner - Cardiovascular Disease (Cardiology) 4587858121 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Georgia Heart Institute LLCGroup PAC ID 4183848062, 127 clinicians

Practice addresses (Care Compare)

1404 River PL
Suite 501
Braselton, GA 30517-5600
Phone (770) 534-2020

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
88.46 of 100Reported as group
Quality
85.33
Promoting interoperability
100
Improvement activities
40
Cost
76.19

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
77489GAMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Georgia Heart Institute LLC Cardiovascular Disease CurrentSince Jun 1, 2020 Accepting new patients
Northeast Georgia Medical Center, Inc. Current Accepting new patients
Northeast Georgia Medical Center, Inc. CurrentSince Jan 22, 2022 Accepting new patients
Northeast Georgia Heart Center Cardiovascular Disease Current Accepting new patients
Indiana University Health Southern Indiana Physicians, LLC Family Medicine PastSince Jun 1, 2020 Accepting new patients

Locations

1404 River Pl
Ste 501
Braselton, GA 30517
Phone (770) 212-3268

4445 S Lee St
Ste 300
Buford, GA 30518
Phone (770) 219-8765

743 Spring St NE
Gainesville, GA 30501
Phone (770) 219-5915

200 S Enota Dr NE
Ste 200
Gainesville, GA 30501
Phone (770) 534-0991

Organizations & group practices 5

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": "1209686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607299200000",
    "number": "1942476643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 742616",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303742616",
            "telephone_number": "770-219-8420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1404 RIVER PL STE 501",
            "city": "BRASELTON",
            "state": "GA",
            "postal_code": "305175600",
            "telephone_number": "770-534-2020",
            "fax_number": "770-534-8025"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOMMURI",
        "first_name": "NAGA",
        "middle_name": "V A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-05-02",
        "last_updated": "2020-12-07",
        "certification_date": "2020-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "GA",
            "license": "77489",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1942476643",
            "state": "MI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "nkommuri106132@nghs.gadirect.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1404 River Pl Ste 501",
            "city": "Braselton",
            "state": "GA",
            "country_code": "US",
            "postal_code": "305175600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Braselton, GA

Sources for this page

Verify at the official NPI Registry.