NPIMap

Individual provider Active NPI

Jeffrey Evan Michaelson, MD

  • Pulmonary Disease Physician
  • Marietta, GA
National Provider Identifier
1063495521
Registry record updated Oct 17, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
037623 Issued in GA
Practice address
55 Whitcher St NE
Suite 160
Marietta, GA 30060-1155
Phone
(770) 422-1372
Fax
(770) 423-9651
NPI assigned
Nov 29, 2005
Last updated
Oct 17, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2019

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine (Internal Medicine) Physician 207RC0200X 037623 GA
Pulmonary Disease Physician 207RP1001X 037623 GA Primary
Sleep Medicine (Internal Medicine) Physician 207RS0012X 37623 GA

Addresses

Primary practice location

55 Whitcher St NE
Suite 160
Marietta, GA 30060-1155

Mailing address

55 Whitcher St NE
Suite 160
Marietta, GA 30060-1155
Phone (770) 422-1372

Other identifiers 11

IdentifierTypeStateIssuer
202I294296OtherGAMEDICARE PTAN
2999766OtherGHI
6054810006OtherCIGNA
00645147CMedicaidGA
290012142OtherGARAILROAD MEDICARE
5341107OtherAETNA
5932OtherGAKAISER
58-1831482OtherGAFEDERAL TAX IDENTIFICATION NUMBER
767305OtherGABLUE CROSS BLUE SHIELD
0932200001OtherGAWORKERS COMPENSATION
4820111OtherUNITED HEALTHCARE

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jmichaelson62589@directwellstar.org

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250416002097 CO Practitioner - Pulmonary Disease 7911077359 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pulmonary Disease
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1050 Wellington Ave
Imh Wellington Lung and Sleep Clinic
Grand Junction, CO 81501-8121
Phone (970) 298-5864

2635 N 7TH St
Grand Junction, CO 81501-8209

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

Merit-based Incentive Payment System (MIPS)

Final score
40.82 of 100Reported as group
Quality
9.1
Promoting interoperability
100
Improvement activities
0
Cost
43.64

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
37623GAMDSleep Medicine (Internal Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Intermountain Medical Group Grand Junction, LLC Current Accepting new patients
Intermountain Medical Group Grand Junction, LLC CurrentSince Feb 6, 2025 Accepting new patients
Intermountain Medical Group Grand Junction, LLC CurrentSince Feb 6, 2025 Accepting new patients
St Mary's Hospital and Medical Center, Inc Past Accepting new patients
Atlanta Pulmonary Group, LLC Pulmonary Disease Past Accepting new patients
Piedmont Providers LLC PastSince Mar 27, 2006 Accepting new patients
Northside Primary Care Professional Services,LLC Past Accepting new patients

Locations

500 Eldorado Blvd
Ste 4300
Broomfield, CO 80021

1050 Wellington Ave
Grand Junction, CO 81501
Phone (970) 245-4810

1050 Wellington Ave
Slp Ctr
Grand Junction, CO 81501
Phone (970) 298-5864

Interoperability endpoints

  • Direct secure messaging: jmichaelson62589@directwellstar.org

Organizations & group practices 7

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": "1133222400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571270400000",
    "number": "1063495521",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 WHITCHER ST NE",
            "address_2": "SUITE 160",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300601155",
            "telephone_number": "770-422-1372",
            "fax_number": "770-423-9651"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 WHITCHER ST NE",
            "address_2": "SUITE 160",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300601155",
            "telephone_number": "770-422-1372",
            "fax_number": "770-423-9651"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MICHAELSON",
        "first_name": "JEFFREY",
        "middle_name": "EVAN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-29",
        "last_updated": "2019-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "GA",
            "license": "037623",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "GA",
            "license": "037623",
            "primary": true
        },
        {
            "code": "207RS0012X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Sleep Medicine",
            "state": "GA",
            "license": "37623",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "202I294296",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI",
            "identifier": "2999766",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "6054810006",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00645147C",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "290012142",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "5341107",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KAISER",
            "identifier": "5932",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FEDERAL TAX IDENTIFICATION NUMBER",
            "identifier": "58-1831482",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "767305",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WORKERS COMPENSATION",
            "identifier": "0932200001",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "4820111",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jmichaelson62589@directwellstar.org",
            "affiliation": "N",
            "address_1": "55 Whitcher St NE",
            "address_2": "Suite 160",
            "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.