EASTSIDE PREMIER NEPHROLOGY & HYPERTENSION PC
NPI 1104048651
Internal Medicine - Nephrology in Conyers, GA

Q: What is Eastside Premier Nephrology & Hypertension PC's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Nephrology, with taxonomy code 207RN0300X.

Active since May 03, 2007

1612 MILSTEAD RD NE, SUITE A, CONYERS, GA 30012(678) 413-3261(678) 413-3580 Get Directions Write a Review

NPPES record last updated: March 22, 2011. Verified against the NPPES registry weekly; last sync: November 01, 2026.

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About Eastside Premier Nephrology & Hypertension Pc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

EASTSIDE PREMIER NEPHROLOGY & HYPERTENSION PC (NPI 1104048651) is a healthcare organization registered as a nephrology in Conyers, Georgia and active in the NPI registry since May 2007. The organization lists Oladapo Falase, Office Manager, as its authorized official.

NPPES Registry Identity

NPI1104048651

Entity TypeOrganization

Primary Taxonomy207RN0300X

Legal Business NameEASTSIDE PREMIER NEPHROLOGY & HYPERTENSION PC

Location Address1612 MILSTEAD RD NE, SUITE AConyers, GA 30012-3738

Mailing AddressPo Box 1157Covington, GA 30015-1157 · (678) 413-3261 · Fax (678) 413-3580

Phone(678) 413-3261

Fax(678) 413-3580

Organization SubpartNo

Authorized OfficialOladapo FalaseOffice Manager · (678) 413-3261

Enumeration DateMay 3, 2007

Last NPPES UpdateMarch 22, 2011

✔ NPI 1104048651 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · NephrologyAllopathic & Osteopathic Physicians

Taxonomy Code207RN0300X

License✔ Licensed in GA · 044714

Definition

An internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation.

1612 MILSTEAD RD NE, Conyers, GA 30012

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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Absolute Total Care, Ambetter Health, Ambetter of Alabama and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Eastside Premier Nephrology & Hypertension Pc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 3 clinicians reassign Medicare billing to Eastside Premier Nephrology & Hypertension PC, which bills Medicare for the services they deliver. Of these, 3 practice at this address. They are listed nearest first.

Clinicians, nearest first (3)

Yilikal Kassa, MD

Nephrology

NPI 1114222676

1612 MILSTEAD RD NE SUITE A
Conyers, GA 30012

(678) 413-3261

✔ PECOS✔ Accepts MedicareSame address

Sitharam Nandigam, MD

Nephrology

NPI 1003096793

1612 MILSTEAD RD NE SUITE A
Conyers, GA 30012

(678) 413-3261

✔ PECOS✔ Accepts MedicareSame address

Nardos Belayneh, M.D

Nephrology

NPI 1326384637

1612 MILSTEAD RD NE STE A
Conyers, GA 30012

(678) 413-3261

✔ PECOS✔ Accepts MedicareSame address

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Eastside Premier Nephrology & Hypertension PC's NPI number?

The NPI number for Eastside Premier Nephrology & Hypertension PC is 1104048651. It was assigned to this organization in the NPPES registry on May 3, 2007.

Where is Eastside Premier Nephrology & Hypertension PC located?

Eastside Premier Nephrology & Hypertension PC is located at 1612 Milstead Rd NE Suite A, Conyers, GA 30012. The listed phone number is (678) 413-3261.

What is Eastside Premier Nephrology & Hypertension PC's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Nephrology, with taxonomy code 207RN0300X.

Is Eastside Premier Nephrology & Hypertension PC enrolled in Medicare?

Yes. Eastside Premier Nephrology & Hypertension PC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Eastside Premier Nephrology & Hypertension PC?

According to the CMS Revalidation Reassignment List (October 2026 release), 3 clinicians, all in Nephrology, reassign their Medicare billing to Eastside Premier Nephrology & Hypertension PC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Of these, 3 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

What insurance does Eastside Premier Nephrology & Hypertension PC accept?

Health plans from Ambetter Health, Ambetter from Absolute Total Care, Ambetter of Alabama, Ambetter of North Carolina and Ambetter of Tennessee list Eastside Premier Nephrology & Hypertension PC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Eastside Premier Nephrology & Hypertension PC was last updated on March 22, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.