Individual provider Active NPI

Puneet Panda, M.D.

  • Ophthalmology Physician
  • Marietta, GA
National Provider Identifier
1073827895
Registry record updated Aug 25, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
75971 Issued in GA
Practice address
895 Canton Rd NE
BLDG 100
Marietta, GA 30060-8934
Phone
(770) 427-8111
Fax
(678) 951-0418
NPI assigned
Aug 4, 2010
Last updated
Aug 25, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 75971 GA Primary

Addresses

Primary practice location

895 Canton Rd NE
BLDG 100
Marietta, GA 30060-8934

Mailing address

895 Canton Rd NE
BLDG 100
Marietta, GA 30060-8934
Phone (770) 427-8111

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
I20160906000538 GA Practitioner - Ophthalmology 7416176839 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
State University of New York at Buffalo School of Medicine, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Marietta Eye Clinic, PAGroup PAC ID 0143210427, 39 clinicians

Practice addresses (Care Compare)

2453 Powder Springs SWRD
Suite 400
Marietta, GA 30064-4570
Phone (770) 801-0700

2990 Eagle Dr
Suite 110
Woodstock, GA 30189-5575
Phone (770) 427-8111

47 Highland Pavilion CT
Suite 101
Hiram, GA 30141-4261
Phone (770) 427-8111

895 Canton Rd NE
BLDG 100
Marietta, GA 30060-8935
Phone (770) 427-8111

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
Cataract surgery430

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
75971GAMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Marietta Eye Clinic PA CurrentSince Aug 1, 2016 Accepting new patients
Marietta Eye Clinic, PA Ophthalmology CurrentSince Aug 1, 2016 Accepting new patients
Marietta Eye Clinic PA Ophthalmology Current Accepting new patients
Marietta Eye Clinic, PA Ophthalmology Past Accepting new patients
Marietta Eye Clinic, PA Ophthalmology Past Accepting new patients

Locations

4450 Calibre Xing NW
Ste 1104
Acworth, GA 30101
Phone (678) 279-1141

100 Old Ball Ground Hwy
#A
Canton, GA 30114

8841 Hospital Dr
Douglasville, GA 30134
Phone (770) 577-2200

47 Highland Pavilion Ct
Hiram, GA 30141
Phone (770) 439-6997

47 Highland Pavilion Ct
Ste 101
Hiram, GA 30141

2453 Powder Springs Rd SW
Ste 400
Marietta, GA 30064
Phone (770) 801-0700

2520 Windy Hill Rd SE
Ste 206
Marietta, GA 30067
Phone (770) 952-6851

3939 Roswell Rd
Ste 100
Marietta, GA 30062
Phone (770) 977-8000

895 Canton Rd NE
Bldg 100
Marietta, GA 30060
Phone (770) 425-6167

895 Canton Rd NE
Bldg 200
Marietta, GA 30060
Phone (678) 784-0203

2990 Eagle Dr
Ste 110
Woodstock, GA 30189
Phone (678) 460-4810

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.

NPI Registry JSON

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

{
    "created_epoch": "1280880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1472083200000",
    "number": "1073827895",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "895 CANTON RD NE",
            "address_2": "BLDG 100",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300608934",
            "telephone_number": "770-427-8111",
            "fax_number": "678-951-0418"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "895 CANTON RD NE",
            "address_2": "BLDG 100",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300608934",
            "telephone_number": "770-427-8111",
            "fax_number": "678-951-0418"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PANDA",
        "first_name": "PUNEET",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-08-04",
        "last_updated": "2016-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "GA",
            "license": "75971",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marietta, GA

Sources for this page

Verify at the official NPI Registry.