ANUDEEP NEELAM – Gastroenterology Physician, NPI 1104385236

ANUDEEP NEELAM is a healthcare provider. based in Suwanee, Georgia. specializing in GASTROENTEROLOGY, INTERNAL MEDICINE. They hold a License No. 103979 (GA). The NPI Number for ANUDEEP NEELAM is 1104385236

Main info

Male
7 Years Of Experience
Accepts Medicare Assignment
Name
ANUDEEP NEELAM
NPI
1104385236
Phone
Not provided
Address
753 MORGANTON DR
Enumeration Date
18 March 2019
Last Update Date
14 April 2025

Doctor Profile

Medical School Name
MEDICAL COLLEGE OF GEORGIA SCHOOL OF MEDICINE
Secondary Phone
4047787525
Graduation Year
2019 (7 years ago)
PAC ID
7315276235
Group Practice PAC ID
8820901408
Professional Enrollment ID
I20250927000021
Address ID
GA303221013AT1365XNEXX400
Telehealth
Yes
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience43
Completeness75
Years active:7State licenses:1Digital endpointsOther names

525 GASTROENTEROLOGY in GA

Provider Addresses for ANUDEEP NEELAM

  • 753 MORGANTON DR

    SUWANEE, GA 300246114

    Phone:

    Type: Mailing

  • 49 JESSE HILL JR DR SE

    ATLANTA, GA 303033049

    Phone: (404) 778-7777

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2025-09-27

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20250927000021IGastroenterologyGATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 30024)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 8820901408View full group profile
NameSpecialtyState
Interventional Cardiology, Cardiovascular Disease (Cardiology), Internal MedicineCA
Internal MedicineGA
Physician AssistantFL
Interventional Radiology, Diagnostic RadiologyKY
Anesthesiology AssistantGA
-CA
D E R M A T O L O G YGA
Interventional Radiology, Diagnostic RadiologyNC
Physician AssistantGA
-GA

Reviews

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Frequently asked questions

What unique ID ties claims to ANUDEEP NEELAM?
NPI 1104385236 is assigned to ANUDEEP NEELAM under the national enumeration system.
Is ANUDEEP NEELAM active in the national directory?
ANUDEEP NEELAM's public NPI profile is in an active state.
What field does ANUDEEP NEELAM work in?
You can think of ANUDEEP NEELAM as practicing within Gastroenterology Physician. Clinical services aligned with this taxonomy classification.
What location shows for ANUDEEP NEELAM?
We surface Suwanee, Georgia for ANUDEEP NEELAM based on available NPPES addresses.
What if Suwanee, Georgia seems incomplete?
Street-level detail can be omitted — open the full address list for this NPI.

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