Matthew Charles Agan, M.D.
Individual provider Active NPI Neurology Physician · Marietta, GA
NPI 1013250679 · NPPES record last updated Aug 15, 2018
Key facts
- NPI
- 1013250679
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Neurology Physician 2084N0400X
- License
- 078898 (GA)
- Practice address
- 780 Canton Rd NE Ste 400
Marietta, GA 30060-7298 - Phone
- (770) 488-3602
- NPI assigned
- Apr 2, 2013
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 3
Hospital & facility affiliations 6
Medicare Care Compare profile
- Specialty
- Neurology
- Education
- Emory University School of Medicine, 2013
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Wellstar Medical Group LLC
Practice addresses (Care Compare)
780 Canton Rd NE
Suite 400
Marietta, GA 30060-7298
Phone (770) 422-3602
Hospital & facility affiliations
- Wellstar Kennestone Regional Medical Center
- Wellstar Cobb Medical Center
- Wellstar North Fulton Medical Center
- Wellstar Paulding Medical Center
- Wellstar Spalding Medical Center
- Wellstar Windy Hill Hospital
Merit-based Incentive Payment System (MIPS)
- Final score
- 93.93 of 100
- Quality
- 82.14
- Promoting interoperability
- 100
- Improvement activities
- 40
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in GA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20181107000802 | GA | Practitioner - Neurology | 9436403672 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Practice roles (3 of 8)
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Wellstar Medical Group, LLC | Current |
Accepting new patients | |
| Wellstar Medical Group, LLC | Current | Accepting new patients | |
| Wellstar Cardiovascular Medicine, LLC | Past | Accepting new patients |
Locations
1364 Clifton Rd NE
Atlanta, GA 30322
Phone (404) 712-7100
8954 Hospital Dr
Douglasville, GA 30134
Phone (678) 838-2584
5150 Stilesboro Rd NW
Ste 220
Kennesaw, GA 30152
Phone (770) 424-8222
780 Canton Rd NE
Ste 400
Marietta, GA 30060
Phone (770) 422-3602
Networks
- devoted network organization-d5084670-562f-408b-b100-22a1a4ef4d82
- devoted network organization-25ba88d3-d0a6-4213-84f1-eef6f2b59f68
- AL HMO D-SNP
- AL HMO
- devoted network organization-14bfd35d-d818-4696-813b-340339e464ef
Interoperability endpoints
- magan176241@directwellstar.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Neurology Physician | 2084N0400X | 078898 | GA | Yes |
Addresses
Primary practice location
780 Canton Rd NE Ste 400
Marietta, GA 30060-7298
Mailing address
780 Canton Rd NE Ste 400
Marietta, GA 30060-7298
Phone (770) 488-3602
Other practice location 1
1364 Clifton Rd NE
Atlanta, GA 30322-1059
Phone (404) 778-0263
Other providers in Marietta, GA
- Afc Physicians of Georgia Urgent Care, PC
- Afc Physicians of Georgia, PC
- Affordable Medical Resources, Inc.
- Jennifer Afman
- Aga, LLC
- Nidhi Agarwal
- Sridevi Agasthi
- Boma Agboh-Stroude
- Kerri Garcia Agee
- Almir Agic
All providers in Marietta, GA · Neurology Physician in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 15, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.