Individual provider Active NPI

Mathew Levine, D.O.

  • Orthopaedic Surgery Physician
  • Cumming, GA
National Provider Identifier
1053621078
Registry record updated Oct 12, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
074072 Issued in GA
Practice address
1100 Northside Forsyth Dr
Suite 340
Cumming, GA 30041-6012
Phone
(770) 886-8111
Fax
(770) 205-8539
NPI assigned
Oct 8, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2016

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X OT013214 PA
Orthopaedic Surgery Physician 207X00000X OS015919 PA
Orthopaedic Surgery Physician 207X00000X E-8622 AR
Orthopaedic Surgery Physician 207X00000X 074072 GA Primary

Addresses

Primary practice location

1100 Northside Forsyth Dr
Suite 340
Cumming, GA 30041-6012

Mailing address

1100 Northside Forsyth Dr
Suite 340
Cumming, GA 30041-6012
Phone (770) 886-8111

Other identifiers 2

IdentifierTypeStateIssuer
003167726BMedicaidGA
003167726AMedicaidGA

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
I20150828001598 GA Practitioner - Orthopedic Surgery 3678889185 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Nova Southeastern Univ College of Dental Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Resurgens, LLCGroup PAC ID 1153224142, 184 clinicians
Physiotherapy Associates IncGroup PAC ID 3577470442, shared by 50 NPIs, 1,432 clinicians
Legacy Healthcare Services IncGroup PAC ID 2163339722, shared by 46 NPIs, 3,431 clinicians

Practice addresses (Care Compare)

1285 Hembree Rd
200A
Roswell, GA 30076-4995
Phone (770) 475-2710

270 Chastain NWRD
Kennesaw, GA 30144-3012
Phone (770) 421-8005

4025 Johns Creek Pkwy
Suite 100
Suwanee, GA 30024-1253
Phone (404) 575-4500

4700 Nelson Brogdon Blvd
Suite 240
Buford, GA 30518-5401
Phone (770) 271-3188

5671 Peachtree Dunwoody Rd
Suite 900
Atlanta, GA 30342-5022

5671 Peachtree Dunwoody Rd NE
Suite 900 950
Atlanta, GA 30342-5022
Phone (404) 847-9999

758 Old Norcross Rd
Suite 100
Lawrenceville, GA 30046-3385
Phone (770) 962-4300

901 Haymon Morris Rd
Winder, GA 30680-7837
Phone (678) 705-2123

Hospital & facility affiliations

  • Tugaloo Home Health Agency, an Amedisy Company Home health agency, Gainesville, GA, CCN 117305
  • Northside Hospital Forsyth Hospital, Cumming, GA, CCN 110005
  • Northeast Georgia Medical Center, Inc Hospital, Gainesville, GA, CCN 110029
  • Northside Hospital Hospital, Atlanta, GA, CCN 110161
  • Wellstar Windy Hill Hospital Long-term care hospital, Marietta, GA, CCN 112007

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
Hip replacement49
Knee replacement45
Lower limb (leg) arthroscopy (minimally invasive joint repair)1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
E-8622ARMDOrthopaedic Surgery Physician
OS015919PAMDOrthopaedic Surgery Physician
OT013214PAMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Resurgens, LLC Orthopaedic Surgery CurrentSince Sep 1, 2015 Accepting new patients
Resurgens, LLC Orthopaedic Surgery CurrentSince Sep 1, 2015 Accepting new patients
Hospital Authority of the City of Bainbridge and Decatur County Past Accepting new patients

Locations

4150 Dep Bill Cantrell Memorial Rd
Ste 300
Cumming, GA 30040
Phone (770) 886-8111

1100 Northside Forsyth Dr
Ste 340
Cumming, GA 30041
Phone (770) 886-8111

1285 Hembree Rd
Ste 200A
Roswell, GA 30076
Phone (770) 475-2710

5671 Ptree Dunwoody Rd NE
Ste 900
Sandy Springs, GA 30342
Phone (404) 531-8590

5671 Ptree Dunwoody Rd NE
Ste 700
Sandy Springs, GA 30342
Phone (404) 459-3732

Interoperability endpoints

  • Direct secure messaging: mathew.levine.1@15749.direct.athenahealth.com

Organizations & group practices 3

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

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": "1286496000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1476230400000",
    "number": "1053621078",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 NORTHSIDE FORSYTH DR",
            "address_2": "SUITE 340",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "300416012",
            "telephone_number": "770-886-8111",
            "fax_number": "770-205-8539"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 NORTHSIDE FORSYTH DR",
            "address_2": "SUITE 340",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "300416012",
            "telephone_number": "770-886-8111",
            "fax_number": "770-205-8539"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEVINE",
        "first_name": "MATHEW",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-10-08",
        "last_updated": "2016-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "PA",
            "license": "OT013214",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "PA",
            "license": "OS015919",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "AR",
            "license": "E-8622",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "GA",
            "license": "074072",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003167726B",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003167726A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cumming, GA

Sources for this page

Verify at the official NPI Registry.