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SUDARSHANA DATTA
NPI 1275096190
Internal Medicine - Interventional Cardiology in Augusta, GA

Active since April 08, 2019PECOS EnrolledAccepts Medicare Assignment
3623 J DEWEY GRAY CIR STE 202, AUGUSTA, GA 30909(706) 863-8155(706) 863-8175 Get Directions Write a Review

NPPES record last updated: May 12, 2026. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: May 12, 2026, Apr 8, 2019 (2 updates tracked since 2019).

About Sudarshana Datta NPPES

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

SUDARSHANA DATTA (NPI 1275096190) is an individual interventional cardiology provider in Augusta, Georgia, licensed in Georgia (104930) and active in the NPI registry since April 2019. She is enrolled in Medicare PECOS, is affiliated with Au Medical Center, and is a graduate of Other (2017).

NPPES Registry Identity

NPI1275096190
Entity TypeIndividualFemale
Primary Taxonomy207RI0011X
Provider Legal NameSUDARSHANA DATTA
Location Address3623 J DEWEY GRAY CIR STE 202Augusta, GA 30909-6554
Mailing Address3623 J Dewey Gray Cir Ste 202Augusta, GA 30909-6554 · (706) 863-8155 · Fax (706) 863-8175
Phone(706) 863-8155
Fax(706) 863-8175
Sole ProprietorNo
Medical School CMSOtherGraduated 2017
Enumeration DateApril 8, 2019
Last NPPES UpdateMay 12, 20262 updates tracked since enumeration
NPPES CertifiedMay 12, 2026
✔ NPI 1275096190 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · Interventional CardiologyAllopathic & Osteopathic Physicians
Taxonomy Code207RI0011X
License✔ Licensed in GA · 104930
Definition
An area of medicine within the subspecialty of cardiology, which uses specialized imaging and other diagnostic techniques to evaluate blood flow and pressure in the coronary arteries and chambers of the heart and uses technical procedures and medications to treat abnormalities that impair the function of the cardiovascular system.
3623 J DEWEY GRAY CIR STE 202, Augusta, GA 30909
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Sudarshana Datta is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID8921341850
PECOS Enrollment IDI20251103001813
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Hospital Affiliations CMS Care Compare 2

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Au Medical Center

Acute Care Hospitals · Augusta, GA
2/5 CMS rating
OwnershipVoluntary non-profit - Other
CMS Certification Number110034
Location1120 15th StreetAugusta, GA 30912 · Richmond County
Emergency services Birthing friendly

Doctors Hospital

Acute Care Hospitals · Augusta, GA
3/5 CMS rating
OwnershipProprietary
CMS Certification Number110177
Location3651 Wheeler RoadAugusta, GA 30909 · Richmond County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 30909 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$124.10 typical visit price
range $53.31 – $164.04
Typical copayment $31.02 (range $13.32 – $41.01)
Most-billed visit code 99204
Established Patient
$94.84 typical visit price
range $16.68 – $133.24
Typical copayment $23.71 (range $4.17 – $33.31)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 4

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. RODOLFO ROZINDO MACHADO M.D.
Internal Medicine (Interventional Cardiology)
3623 J DEWEY GRAY CIR STE 202
AUGUSTA, GA 30909
Richmond County (706) 863-8155
ABHIGYAN MUKHERJEE M.D.
Internal Medicine (Interventional Cardiology)
3623 J DEWEY GRAY CIR STE 202
AUGUSTA, GA 30909
Richmond County (706) 863-8155
ROBERT STEVEN BLACKWELDER
Nurse Practitioner (Acute Care)
3623 J DEWEY GRAY CIR STE 202
AUGUSTA, GA 30909
Richmond County (706) 863-8181
PHONG JASON NGUYEN DO
Internal Medicine (Interventional Cardiology)
3623 J DEWEY GRAY CIR STE 202
AUGUSTA, GA 30909
Richmond County (067) 863-8155

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 Sudarshana Datta's NPI number?

The NPI number for Sudarshana Datta is 1275096190. It was assigned to this individual provider in the NPPES registry on April 8, 2019.

Where is Sudarshana Datta located?

Sudarshana Datta practices at 3623 J Dewey Gray Cir Ste 202, Augusta, GA 30909. The listed phone number is (706) 863-8155.

What is Sudarshana Datta's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Interventional Cardiology, with taxonomy code 207RI0011X.

Is Sudarshana Datta enrolled in Medicare?

Yes. Sudarshana Datta is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Is Sudarshana Datta affiliated with any hospitals?

According to CMS data, Sudarshana Datta is affiliated with Au Medical Center and Doctors Hospital.

When was this NPI record last updated?

The NPPES record for Sudarshana Datta was last updated on May 12, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 months 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.