| Shanthan Pendem, MD | |
|
1400 River Pl, Braselton, GA 30517-5600 | |
| (770) 848-8000 | |
| (770) 848-8601 |
| Full Name | Shanthan Pendem |
|---|---|
| Gender | Male |
| Speciality | Critical Care (intensivists) |
| Experience | 28 Years |
| Location | 1400 River Pl, Braselton, Georgia |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659425817 | NPI | - | NPPES |
| P00256319 | Other | ND | RR MEDICARE |
| 13617 | Medicaid | ND |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 9882 (North Dakota) | Secondary |
| 207RC0200X | Internal Medicine - Critical Care Medicine | 68271 (Georgia) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Piedmont Henry Hospital | Stockbridge, GA | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Gwinnett Pulmonary Group | 1153317615 | 16 |
| Piedmont Specialty Hospital Billing Llc | 4183986490 | 202 |
| Entity Name | The Emory Clinic Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1396798229 PECOS PAC ID: 8820901408 Enrollment ID: O20031110000503 |
| Entity Name | Northeast Georgia Physicians Group Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1891745212 PECOS PAC ID: 6901898386 Enrollment ID: O20040402001277 |
| Entity Name | Gwinnett Pulmonary Group |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1801974175 PECOS PAC ID: 1153317615 Enrollment ID: O20040421001310 |
| Entity Name | Emory Specialty Associates, Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1407864168 PECOS PAC ID: 3476559782 Enrollment ID: O20061010000447 |
| Entity Name | Piedmont Specialty Hospital Billing Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1699290510 PECOS PAC ID: 4183986490 Enrollment ID: O20180327001180 |
| Mailing Address | Practice Location Address |
|---|---|
| Shanthan Pendem, MD Po Box 742616, Atlanta, GA 30374-2616 Ph: (770) 219-8420 | Shanthan Pendem, MD 1400 River Pl, Braselton, GA 30517-5600 Ph: (770) 848-8000 |
Siva Chiranjeevi, MD Critical Care Medicine Medicare: Accepting Medicare Assignments Practice Location: 1404 River Pl Ste 501, Braselton, GA 30517 Phone: 770-534-2020 | |
Mr. Rana Zouveenoor Tariq, M.D Critical Care Medicine Medicare: Accepting Medicare Assignments Practice Location: 1404 River Pl Ste 501, Braselton, GA 30517 Phone: 770-534-2020 | |
Champak Patel, MD Critical Care Medicine Medicare: Not Enrolled in Medicare Practice Location: 5196 Hwy 53, Braselton, GA 30517 Phone: 706-824-9929 Fax: 706-654-9373 | |
Dr. Nima Ghasemzadeh, MD Critical Care Medicine Medicare: Accepting Medicare Assignments Practice Location: 1404 River Pl Ste 501, Braselton, GA 30517 Phone: 770-534-2020 Fax: 770-534-8025 | |
Zaid Houfdhi Said, MD Critical Care Medicine Medicare: Accepting Medicare Assignments Practice Location: 1404 River Pl Ste 501, Braselton, GA 30517 Phone: 770-534-2020 Fax: 770-534-8025 | |
Dr. Mulualem Yigzaw Teferi, M.D. Critical Care Medicine Medicare: Accepting Medicare Assignments Practice Location: 1400 River Pl, Braselton, GA 30517 Phone: 770-219-6000 | |
Katelyn Amanda Boykin, DO Critical Care Medicine Medicare: Medicare Enrolled Practice Location: 1515 River Pl Ste 340, Braselton, GA 30517 Phone: 770-419-4840 |