Individual provider Active NPI

Bryan T. Piedad, M.D.

  • Clinical Cardiac Electrophysiology Physician
  • Marietta, GA
National Provider Identifier
1033170683
Registry record updated Nov 25, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Cardiac Electrophysiology PhysicianTaxonomy code 207RC0001X
License
55779 Issued in GA
Practice address
55 Whitcher St NE
Suite 350
Marietta, GA 30060-1155
Phone
(770) 424-6893
Fax
(770) 528-9938
NPI assigned
Mar 31, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 25, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Nuclear Imaging & Therapy Physician 207UN0902X 55779 GA
Clinical Cardiac Electrophysiology Physician 207RC0001X 55779 GA Primary
Cardiovascular Disease Physician 207RC0000X 55779 GA
Nuclear Cardiology Physician 207UN0901X 55779 GA

Addresses

Primary practice location

55 Whitcher St NE
Suite 350
Marietta, GA 30060-1155

Mailing address

55 Whitcher St NE
Suite 350
Marietta, GA 30060-1155
Phone (770) 424-6893

Other identifiers 5

IdentifierTypeStateIssuer
258441706SMedicaidGA
258441706QMedicaidGA
258441706PMedicaidGA
258441706RMedicaidGA
258441706TMedicaidGA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address bpiedad28546@directwellstar.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050628001067 GA Practitioner - Cardiac ElectrophysiologyPractitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 6709822927 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiac ElectrophysiologyAlso: Cardiovascular Disease (Cardiology)
Education
University of Rochester School of Medicine and Dentistry, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wellstar Medical Group LLCGroup PAC ID 6709065402, 3,059 clinicians

Practice addresses (Care Compare)

1120 Wellstar Way
Holly Springs, GA 30114-8929

120 Stonebridge Pkwy
Woodstock, GA 30189-3768

144 Bill Carruth Pkwy
Hiram, GA 30141-3819

148 Bill Carruth Pkwy
Hiram, GA 30141-3756

1700 Hospital S Dr
Austell, GA 30106-8159

2518 Jimmy Lee Smith Pkwy
Hiram, GA 30141-2068
Phone (770) 732-4022

2540 Windy Hill Rd
Marietta, GA 30067-8605
Phone (770) 644-1570

2540 Windy Hill Serd
Marietta, GA 30067-8605
Phone (770) 644-1274

2550 Windy Hill Rd SE
Suite 220
Marietta, GA 30067-8605
Phone (404) 321-9900

3747 Roswell Rd
Marietta, GA 30062-6227

3950 Austell Rd
Austell, GA 30106-1121
Phone (770) 732-4022

4500 Hospital Blvd
Roswell, GA 30076-0001

5150 Stilesboro N W Rd
Suite 220
Kennesaw, GA 30152-7742
Phone (770) 424-8222

55 Whitcher Nest
Suite 160
Marietta, GA 30060-1160
Phone (770) 422-1372

6001 Professional Pkwy
Douglasville, GA 30134-5632

625 Church Nest
Marietta, GA 30060-1101
Phone (770) 422-2004

677 Church Nest
Marietta, GA 30060-1101

677 Church St NE
Suite 100P
Marietta, GA 30060-1101
Phone (470) 793-8585

8954 Hospital Dr
Douglasville, GA 30134-2272
Phone (678) 838-2585

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.93 of 100Reported as apm
Quality
82.14
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Pacemaker insertion or repair52

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
55779GAMDNuclear Cardiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wellstar Medical Group, LLC CurrentSince Dec 1, 2013 Accepting new patients
Wellstar Medical Group, LLC Current Accepting new patients
Wellstar Medical Group, LLC CurrentSince Dec 1, 2013 Accepting new patients
Saint Josephs Hospital of Atlanta Inc Past Accepting new patients
Wellstar Cardiovascular Medicine, LLC Cardiovascular Disease Past Accepting new patients

Locations

720 Transit Ave
Ste 102
Canton, GA 30114
Phone (770) 426-4721

40 Fox Chase
Cartersville, GA 30120
Phone (678) 400-2621

5150 Stilesboro Rd NW
Ste 220
Kennesaw, GA 30152
Phone (770) 424-8222

5150 Stilesboro Rd NW
Ste 120
Kennesaw, GA 30152
Phone (678) 354-0230

805 Sandy Plains Rd
Marietta, GA 30066
Phone (770) 792-1616

55 Whitcher St NE
Ste 430
Marietta, GA 30060
Phone (770) 819-9211

355 Tower Rd NE
Ste 300
Marietta, GA 30060
Phone (770) 426-4721

55 Whitcher St NE
Ste 160
Marietta, GA 30060
Phone (770) 590-4180

55 Whitcher St NE
Ste 350
Marietta, GA 30060

677 Church St NE
Marietta, GA 30060
Phone (770) 793-5435

3000 Hospital Blvd
Roswell, GA 30076
Phone (770) 751-2500

120 Stonebridge Pkwy
Ste 110
Woodstock, GA 30189
Phone (678) 324-4400

120 Stonebridge Pkwy
Ste 440
Woodstock, GA 30189
Phone (770) 250-7199

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1143763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574640000000",
    "number": "1033170683",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 WHITCHER ST NE",
            "address_2": "SUITE 350",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300601155",
            "telephone_number": "770-424-6893",
            "fax_number": "770-528-9938"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 WHITCHER ST NE",
            "address_2": "SUITE 350",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300601155",
            "telephone_number": "770-424-6893",
            "fax_number": "770-528-9938"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PIEDAD",
        "first_name": "BRYAN",
        "middle_name": "T.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-31",
        "last_updated": "2019-11-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207UN0902X",
            "taxonomy_group": "",
            "desc": "Nuclear Medicine, Nuclear Imaging & Therapy",
            "state": "GA",
            "license": "55779",
            "primary": false
        },
        {
            "code": "207RC0001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Clinical Cardiac Electrophysiology",
            "state": "GA",
            "license": "55779",
            "primary": true
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "GA",
            "license": "55779",
            "primary": false
        },
        {
            "code": "207UN0901X",
            "taxonomy_group": "",
            "desc": "Nuclear Medicine, Nuclear Cardiology",
            "state": "GA",
            "license": "55779",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "258441706S",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "258441706Q",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "258441706P",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "258441706R",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "258441706T",
            "state": "GA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "bpiedad28546@directwellstar.org",
            "affiliation": "N",
            "address_1": "55 Whitcher St NE",
            "address_2": "Suite 350",
            "city": "Marietta",
            "state": "GA",
            "country_code": "US",
            "postal_code": "300601155",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Marietta, GA

Sources for this page

Verify at the official NPI Registry.