Active NPI
Padmini Gunadeva, MD
- Family Medicine Physician
- Lilburn, GA
National Provider Identifier
1962451849
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 044734
- Practice address
- 455 Beaver Ruin Rd NW
Lilburn, GA 30047-3413 - Phone
- (770) 923-7778
- Fax
- (770) 806-1383
- NPI assigned
- May 9, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 044734 | GA | Primary |
Addresses
Primary practice location
455 Beaver Ruin Rd NW
Lilburn, GA 30047-3413
Mailing address
10600 Medlock Bridge Rd
Duluth, GA 30097-8404
Other practice location 1
175 N Broad St
Winder, GA 30680-2153
Phone (770) 868-1144
Other practice location 2
2764 Main St W
Snellville, GA 30078-5708
Phone (770) 978-3388
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- Education
- Other, 1984
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
175 N Broad St
Winder, GA 30680-2153
Phone (770) 868-1144
Hospital & facility affiliations
- Central Home Health Care, an Amedisys Company
- Piedmont Eastside Medical Center
- Northside Hospital Gwinnett
Merit-based Incentive Payment System (MIPS)
- Final score
- 75 of 100
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 044734 | GA | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Gwinnett Clinic, LTD | Family Medicine | Current | Accepting new patients |
| Gwinnett Clinic LTD | Current | Accepting new patients | |
| Gwinnett Clinic, LTD | Family Medicine | Current | Accepting new patients |
| Gwinnett Clinic, LTD | Family Medicine | Past | Accepting new patients |
Locations
10600 Medlock Bridge Rd
Johns Creek, GA 30097
Phone (770) 418-0818
475 Philip Blvd
Ste 100
Lawrenceville, GA 30046
Phone (678) 226-6202
455 Beaver Ruin Rd NW
Lilburn, GA 30047
Phone (770) 923-7778
2764 W Main St
Snellville, GA 30078
Phone (770) 978-3388
175 N Broad St
Winder, GA 30680
Phone (770) 868-1144
Interoperability endpoints
- padmini.gunadeva@gclinic.emedpractice.direct-ci.com
- padmini.gunadeva.1@32352.direct.athenahealth.com
Organizations & group practices 4
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.
-
- Multi-Specialty Clinic/Center
- Duluth, GA
- NPI 1629117650
Hospital & facility affiliations 3
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Home Health Agency
- Tucker, GA
- NPI 1477501179
-
- General Acute Care Hospital
- Snellville, GA
- NPI 1467406132
-
- General Acute Care Hospital
- Lawrenceville, GA
- NPI 1952340994
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147132800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1673654400000",
"number": "1962451849",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10600 MEDLOCK BRIDGE RD",
"city": "DULUTH",
"state": "GA",
"postal_code": "300978404"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "455 BEAVER RUIN RD NW",
"city": "LILBURN",
"state": "GA",
"postal_code": "300473413",
"telephone_number": "770-923-7778",
"fax_number": "770-806-1383"
}
],
"practiceLocations": [
{
"address_1": "175 N Broad St",
"address_purpose": "LOCATION",
"city": "Winder",
"state": "GA",
"postal_code": "306802153",
"country_code": "US",
"telephone_number": "770-868-1144",
"fax_number": "770-868-1276",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "2764 Main St W",
"address_purpose": "LOCATION",
"city": "Snellville",
"state": "GA",
"postal_code": "300785708",
"country_code": "US",
"telephone_number": "770-978-3388",
"fax_number": "770-978-0807",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "GUNADEVA",
"first_name": "PADMINI",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-05-09",
"last_updated": "2023-01-14",
"certification_date": "2023-01-12",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "GA",
"license": "044734",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lilburn, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.