HERITAGE MEDICAL MANAGEMENT GROUP LLC
NPI 1710858592
Surgery - Vascular Surgery in Atlanta, GA

Q: What is Heritage Medical Management Group LLC's specialty?

The primary specialty registered for this NPI is Surgery, specializing in Vascular Surgery, with taxonomy code 2086S0129X.

Active since September 15, 2025

777 CLEVELAND AVE SW, ATLANTA, GA 30315(404) 755-2291(732) 347-3388 Get Directions Write a Review

NPPES record last updated: August 24, 2026. Verified against the NPPES registry weekly; last sync: November 08, 2026.

Record update history: Aug 24, 2026, Apr 28, 2026, Feb 7, 2026 and 2 more (5 updates tracked since 2025).

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About Heritage Medical Management Group Llc NPPES

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

HERITAGE MEDICAL MANAGEMENT GROUP LLC (NPI 1710858592) is a healthcare organization registered as a vascular surgery in Atlanta, Georgia and active in the NPI registry since September 2025. The organization lists Steve O Odeh, Ceo, as its authorized official.

NPPES Registry Identity

NPI1710858592

Entity TypeOrganization

Primary Taxonomy2086S0129X

Legal Business NameHERITAGE MEDICAL MANAGEMENT GROUP LLC

Location Address777 CLEVELAND AVE SWAtlanta, GA 30315-7129

Mailing Address777 Cleveland Ave SwAtlanta, GA 30315-7129 · (678) 621-0421 · Fax (732) 347-3388

Phone(404) 755-2291

Fax(732) 347-3388

Organization SubpartNo

Authorized OfficialSteve O OdehCeo · (404) 242-9621

Enumeration DateSeptember 15, 2025

Last NPPES UpdateAugust 24, 20265 updates tracked since enumeration

NPPES CertifiedAugust 24, 2026

✔ NPI 1710858592 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySurgery · Vascular SurgeryAllopathic & Osteopathic Physicians

Taxonomy Code2086S0129X

Definition

A surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart.

777 CLEVELAND AVE SW, Atlanta, GA 30315

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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Heritage Medical Management Group Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 2 clinicians reassign Medicare billing to Heritage Medical Management Group LLC, which bills Medicare for the services they deliver. They are listed nearest first.

Clinicians, nearest first (2)

Mylene Lilian Gonzales

Nurse Practitioner

NPI 1396345948

4700 OGEECHEE DR
Johns Creek, GA 30022

(770) 403-2186

✔ PECOS✔ Accepts Medicare27 mi

Steve Odeh, M.D

Vascular Surgery

NPI 1801940200

509 ALABAMA AVE S
Bremen, GA 30110

(770) 537-5555

✔ PECOS✔ Accepts Medicare42 mi

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 Heritage Medical Management Group LLC's NPI number?

The NPI number for Heritage Medical Management Group LLC is 1710858592. It was assigned to this organization in the NPPES registry on September 15, 2025.

Where is Heritage Medical Management Group LLC located?

Heritage Medical Management Group LLC is located at 777 Cleveland Ave SW, Atlanta, GA 30315. The listed phone number is (404) 755-2291.

What is Heritage Medical Management Group LLC's specialty?

The primary specialty registered for this NPI is Surgery, specializing in Vascular Surgery, with taxonomy code 2086S0129X.

Is Heritage Medical Management Group LLC enrolled in Medicare?

Yes. Heritage Medical Management Group LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Heritage Medical Management Group LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 2 clinicians reassign their Medicare billing to Heritage Medical Management Group LLC, in Nurse Practitioner and Vascular Surgery. 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. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Heritage Medical Management Group LLC was last updated on August 24, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.