Gautam Jagoo (NPI# 1124092986, PAC ID# 9133150600) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is DIAGNOSTIC RADIOLOGY.
| Nation Provider ID (NPI) | 1124092986 |
| PAC ID by PECOS | 9133150600 |
| Professional Enrollment ID | I20050824000612 |
| Full Name | Gautam Jagoo |
| Organization Legal Name | PREFERRED VASCULAR SERVICES SOUTHWEST |
| Address |
3885 Princeton Lakes Way Sw Suite 314 Atlanta GA 30331-7100 |
| Phone Number | 4043497770 |
| Gender | M |
| Credential | MD |
| Medical School | TUFTS UNIVERSITY SCHOOL OF MEDICINE |
| Graduation Year | 1999 |
| Primary Specialty | DIAGNOSTIC RADIOLOGY |
| Secondary Specialties | INTERVENTIONAL RADIOLOGY |
| Group Practice PAC ID | 0446502918 |
| Number of Group Practice Members | 5 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 110192 | EASTSIDE MEDICAL CENTER |
| 110087 | GWINNETT MEDICAL CENTER |
| 110010 | EMORY UNIVERSITY HOSPITAL |
| Address | Phone | Organization |
|---|---|---|
| 1 Dunwoody Park, Suite 140, Atlanta, GA 30338-6708 | 4045542080 | PREFERRED VASCULAR SERVICES NORTHEAST |
| 3885 Princeton Lakes Way Sw, Suite 314, Atlanta, GA 30331-7100 | 4043497770 | PREFERRED VASCULAR SERVICES SOUTHWEST |
| 3885 Princeton Lakes Way Sw, Suite 314, Atlanta, GA 30331-7100 | PREFERRED VASCULAR SERVICES NORTHWEST LLC | |
| 5461 Hillandale Dr, Suite 210, Lithonia, GA 30058-4842 | 7709818477 | PREFERRED VASCULAR SERVICES NORTHWEST LLC |
| 5461 Hillandale Dr, Suite 210, Lithonia, GA 30058-4842 | PREFERRED VASCULAR SERVICES SOUTHEAST LLC | |
| 1700 Medical Way, Snellville, GA 30078-2195 | 7709790200 | SOUTH GWINNETT RADIOLOGY PC |
| 1700 Tree Ln, Suite 100, Snellville, GA 30078-6749 | 7707792184 | SOUTH GWINNETT RADIOLOGY PC |
| Measure Identifier | Measure Title | Performance Rate | Reporting Mechanism |
|---|---|---|---|
| MIPS_EC_076_overall | Prevention of Central Venous Catheter (CVC) - Related Bloodstream Infections | 100% | |
| MIPS_EC_145_overall | Radiology: Exposure Dose or Time Reported for Procedures Using Fluoroscopy | 100% | |
| MIPS_EC_195_overall | Radiology: Stenosis Measurement in Carotid Imaging Reports | 100% | |
| MIPS_EC_436_overall | Radiation Consideration for Adult CT: Utilization of Dose Lowering Techniques | 100% |
| Organization Legal Name | PREFERRED VASCULAR SERVICES SOUTHWEST |
| Physicians | 5 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Shrenik Pankaj Shah | Interventional Radiology | Preferred Vascular Services Southwest | 3885 Princeton Lakes Way Sw, Suite 314, Atlanta, GA 30331-7100 |
| Anthony D Goei | Interventional Radiology | Preferred Vascular Services Southwest | 3885 Princeton Lakes Way Sw, Suite 314, Atlanta, GA 30331-7100 |
| Manish P Govin | Diagnostic Radiology | Preferred Vascular Services Southwest | 3885 Princeton Lakes Way Sw, Suite 314, Atlanta, GA 30331-7100 |
| Andrei Kranz | Diagnostic Radiology | Preferred Vascular Services Southwest | 3885 Princeton Lakes Way Sw, Suite 314, Atlanta, GA 30331-7100 |
| Street Address |
3885 PRINCETON LAKES WAY SW SUITE 314 |
| City | ATLANTA |
| State | GA |
| Zip | 30331-7100 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Shrenik Pankaj Shah | Interventional Radiology | Preferred Vascular Services Southwest | 3885 Princeton Lakes Way Sw, Suite 314, Atlanta, GA 30331-7100 |
| Anthony D Goei | Interventional Radiology | Preferred Vascular Services Southwest | 3885 Princeton Lakes Way Sw, Suite 314, Atlanta, GA 30331-7100 |
| Manish P Govin | Diagnostic Radiology | Preferred Vascular Services Southwest | 3885 Princeton Lakes Way Sw, Suite 314, Atlanta, GA 30331-7100 |
| Andrei Kranz | Diagnostic Radiology | Preferred Vascular Services Southwest | 3885 Princeton Lakes Way Sw, Suite 314, Atlanta, GA 30331-7100 |
| Ewaul B Persaud | Internal Medicine | Premier South Medical Group PC | 3885 Princeton Lakes Way Sw, Suite 412, Atlanta, GA 30331-5599 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Tamara Brown | Internal Medicine | 5835 Cambellton Rd Sw, Atlanta, GA 30331 | |
| David W Tascarella | Psychiatry | Eye Listen Empowerment Center, LLC | 3201 Atlanta Industrial Pkwy Nw, Suite 302, Atlanta, GA 30331-1048 |
| George D Angelich | Clinical Social Worker | Eye Listen Empowerment Center, LLC | 3201 Atlanta Industrial Pkwy Nw, Suite 302, Atlanta, GA 30331-1048 |
| Cornelius C Grimes | Clinical Social Worker | 920 Dannon Vw Sw, Suite 3104, Atlanta, GA 30331-2157 | |
| Claudia Ayodele Davies Hodge | Nurse Practitioner | D L Murray Md PC | 920 Dannon Vw Sw, Suite 3103, Atlanta, GA 30331-2158 |
| Edith M Fresh | Psychologist, Clinical | 920 Dannon View Sw, Suite 3104, Atlanta, GA 30331-2158 | |
| Toniah Paryo | Nurse Practitioner | D L Murray Md PC | 920 Dannon Vw Sw, Suite 3103, Atlanta, GA 30331-2158 |
| Darrell Lee Murray Sr. | Family Medicine | D L Murray Md PC | 920 Dannon Vw Sw, Suite 3103, Atlanta, GA 30331-2158 |
| Sherra B Conde | Chiropractic | 1195 Fairburn Swrd, Suite 150, Atlanta, GA 30331-2162 | |
| Yvonne Ukwu | Internal Medicine | Piedmont Medical Care Corporation | 3699 Cascade Swrd, B2, Atlanta, GA 30331-2163 |
| Find all physicians in zip 30331 | |||
| City | ATLANTA |
| Zip Code | 30331 |
| Specialty | DIAGNOSTIC RADIOLOGY |
| City + Specialty | ATLANTA + DIAGNOSTIC RADIOLOGY |
Please comment or provide details below to improve the information on Gautam Jagoo.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.