Individual provider Active NPI

Naland P Shenoy, MD

  • Endocrinology, Diabetes & Metabolism Physician
  • Snellville, GA
National Provider Identifier
1972598852
Registry record updated Dec 2, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
053165 Issued in GA
Practice address
2121 Fountain Dr Ste J
Snellville, GA 30078-2900
Phone
(770) 979-7466
Fax
(770) 979-7455
NPI assigned
Sep 15, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Endocrinology, Diabetes & Metabolism Physician 207RE0101X 053165 GA Primary
Endocrinology, Diabetes & Metabolism Physician 207RE0101X 22558 SC

Addresses

Primary practice location

2121 Fountain Dr Ste J
Snellville, GA 30078-2900

Mailing address

2121 Fountain Dr Ste J
Snellville, GA 30078-2900
Phone (770) 979-7466

Other identifiers 4

IdentifierTypeStateIssuer
DH0728OtherGARR MEDICARE GROUP NUMBER
52057418002OtherGABCBS PROVIDER
7677440OtherGAAETNA PROVIDER #
P00037925OtherGARAILROAD MEDICARE

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
I20040616000713 GA Practitioner - Endocrinology 6709871619 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Endocrinology
Education
Medical University of South Carolina College of Medicine, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2121 Fountain Dr
Suite J
Snellville, GA 30078-2900
Phone (770) 979-7466

Hospital & facility affiliations

  • Piedmont Eastside Medical Center Hospital, Snellville, GA, CCN 110192

Merit-based Incentive Payment System (MIPS)

Final score
94.51 of 100Reported as apm
Quality
80.61
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
22558SCMDEndocrinology, Diabetes & Metabolism Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Diabetes and Endocrinology of Snellville, LLC Endocrinology, Diabetes & Metabolism CurrentSince Oct 1, 2019 Accepting new patients

Locations

2121 Fountain Dr
Ste J
Snellville, GA 30078
Phone (770) 979-7466

Interoperability endpoints

  • Direct secure messaging: naland.shenoy.1@30855.direct.athenahealth.com
  • FHIR API: https://fhir4.healow.com/fhir/r4/GJDIDD
  • FHIR API: https://fhir4.healow.com/fhir/r4/GJDIDD/Endpoint/GJDIDD

Organizations & group practices 1

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 1

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": "1126742400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1575244800000",
    "number": "1972598852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2121 FOUNTAIN DR STE J",
            "city": "SNELLVILLE",
            "state": "GA",
            "postal_code": "300782900",
            "telephone_number": "770-979-7466",
            "fax_number": "770-979-7455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2121 FOUNTAIN DR STE J",
            "city": "SNELLVILLE",
            "state": "GA",
            "postal_code": "300782900",
            "telephone_number": "770-979-7466",
            "fax_number": "770-979-7455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHENOY",
        "first_name": "NALAND",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-15",
        "last_updated": "2019-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "GA",
            "license": "053165",
            "primary": true
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "SC",
            "license": "22558",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE GROUP NUMBER",
            "identifier": "DH0728",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDER",
            "identifier": "52057418002",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA PROVIDER #",
            "identifier": "7677440",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00037925",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Snellville, GA

Sources for this page

Verify at the official NPI Registry.