DR. JAYDEEP KUMAR RADHAKRISHNAN (M.D.) – Family Medicine Physician, NPI 1730335407

DR. JAYDEEP KUMAR RADHAKRISHNAN (M.D.) is a healthcare provider. based in Altanta, Georgia. specializing in FAMILY PRACTICE. They hold the professional credentials M.D.. They hold a License No. 66050 (GA). The NPI Number for DR. JAYDEEP KUMAR RADHAKRISHNAN (M.D.) is 1730335407

Main info

Male
19 Years Of Experience
Accepts Medicare Assignment
Name
DR. JAYDEEP KUMAR RADHAKRISHNAN (M.D.)
NPI
1730335407
Phone
(770) 677-6037
Address
20 GLENLAKE PARKWAY
Enumeration Date
13 August 2008
Last Update Date
4 October 2022

Doctor Profile

Medical School Name
OTHER
Secondary Phone
4043647206
Graduation Year
2007 (19 years ago)
PAC ID
2466621461
Group Practice PAC ID
6204829013
Professional Enrollment ID
I20110809000207
Address ID
GA303051729AT3495XNEXX400

Contacts

SOAP Endpoint
https://careepiceast.kp.org:14430/Interconnect-prodgam/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience67
Completeness85
Years active:17State licenses:2Other namesUpdated within 12 months

3,103 FAMILY PRACTICE in GA

Provider Addresses for DR. JAYDEEP KUMAR RADHAKRISHNAN (M.D.)

  • 20 GLENLAKE PARKWAY

    KAISER PERMANENTE GLENLAKE MEDICAL CENTER

    ALTANTA, GA 30328

    Phone: (770) 677-6037

    Type: Location

  • 3495, Piedmont Road Northeast, Buckhead, Atlanta, Georgia, 30305, United States

    NINE PIEDMONT CENTER

    ATLANTA, GA 30305

    Phone: (404) 364-7070

    Type: Mailing

  • 3495 PIEDMONT RD NE

    NINE PIEDMONT CENTER

    ATLANTA, GA 303051717

    Phone: (404) 364-7070

    Type: Mailing

  • 1435 BROADMOOR BLVD

    SUGAR HILL, GA 30518

    Phone: (404) 365-0966

    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: 2011-08-09

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
I20110809000207IFamily PracticeGATBD

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 30328)

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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: 6204829013View full group profile

Reviews

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Frequently asked questions

Can I verify DR. JAYDEEP KUMAR RADHAKRISHNAN (M.D.) with an NPI only?
You can start verification with NPI 1730335407 for DR. JAYDEEP KUMAR RADHAKRISHNAN (M.D.), then check state licensing separately.
Can I rely on DR. JAYDEEP KUMAR RADHAKRISHNAN (M.D.) being an active provider?
As of the registry snapshot, DR. JAYDEEP KUMAR RADHAKRISHNAN (M.D.) is marked active.
What is DR. JAYDEEP KUMAR RADHAKRISHNAN (M.D.)'s primary classification?
Family Medicine Physician is the headline specialty for DR. JAYDEEP KUMAR RADHAKRISHNAN (M.D.) here. Clinical services aligned with this taxonomy classification.
What address line appears for DR. JAYDEEP KUMAR RADHAKRISHNAN (M.D.)?
DR. JAYDEEP KUMAR RADHAKRISHNAN (M.D.)'s geographic hint is Altanta, Georgia in our summary view.
Is the information about DR. JAYDEEP KUMAR RADHAKRISHNAN (M.D.) up to date?
Data updates when providers file changes in NPPES — treat critical facts as "verify if unsure."