| Jayashree Venkatesh, MD | |
|
1435 Broadmoor Blvd, Kaiser Permanente Sugar Hill-buford Medical Center, Sugar Hill, GA 30518 | |
| (678) 765-5700 | |
| (540) 636-8920 |
| Full Name | Jayashree Venkatesh |
|---|---|
| Gender | Female |
| Speciality | Family Medicine |
| Location | 1435 Broadmoor Blvd, Sugar Hill, Georgia |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1851366454 | NPI | - | NPPES |
| P00670504 | Other | VA | MEDICARE RR |
| 010147735 | Medicaid | VA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 0101237911 (Virginia) | Secondary |
| 207Q00000X | Family Medicine | 065912 (Georgia) | Primary |
| Entity Name | The Southeast Permanente Medical Group |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1245266956 PECOS PAC ID: 6204829013 Enrollment ID: O20040407000370 |
| Mailing Address | Practice Location Address |
|---|---|
| Jayashree Venkatesh, MD 3495 Piedmont Road, Ne, Nine Piedmont Center, Atlanta, GA 30305 Ph: (404) 504-5678 | Jayashree Venkatesh, MD 1435 Broadmoor Blvd, Kaiser Permanente Sugar Hill-buford Medical Center, Sugar Hill, GA 30518 Ph: (678) 765-5700 |
Ms. Matilda Mabel Antwi, NP Family Medicine Medicare: Medicare Enrolled Practice Location: 715 River Rush Dr, Sugar Hill, GA 30518 Phone: 630-202-6958 | |
Dr. Jaydeep Kumar Radhakrishnan, M.D. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 1435 Broadmoor Blvd, Sugar Hill, GA 30518 Phone: 404-365-0966 |