Manogna Maddineni, M.D

Primary specialty

Hospitalist PhysicianTaxonomy code 208M00000X

License

06549 Issued in GA

Practice address

677 Church St NE # 111
Marietta, GA 30060-1101

Phone

(770) 793-7750

NPI assigned

May 7, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

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

Specialty

HospitalistAlso: Internal Medicine

Education

Other, 2001

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)

Hospital & facility affiliations

• Wellstar Douglas Medical Center Hospital, Douglasville, GA, CCN 110184
• Wellstar Cobb Medical Center Hospital, Austell, GA, CCN 110143

Merit-based Incentive Payment System (MIPS)

Final score

93.93 of 100Reported as apm

Quality

82.14

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mmaddineni67805@directwellstar.org

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.

• Wellstar Medical Group, LLC

  • Family Medicine Physician
  • Kennesaw, GA
  • NPI 1558664003
  Medicare reassignment Care Compare group NPD
• The Emory Clinic Inc

  • Internal Medicine Physician
  • Atlanta, GA
  • NPI 1396798229
  Medicare reassignment NPD
• Wellstar Medical Group, LLC

  • Surgery Physician
  • Douglasville, GA
  • NPI 1164715132
  NPD
• Wellstar Medical Group, LLC

  • Multi-Specialty Clinic/Center
  • Marietta, GA
  • NPI 1275992240
  NPD
• Douglas Hospital, Inc.

  • General Acute Care Hospital
  • Douglasville, GA
  • NPI 1649247974
  NPD (past)

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

• Cobb Hospital, Inc

  • General Acute Care Hospital
  • Austell, GA
  • NPI 1467420448
  Care Compare affiliation
• Douglas Hospital, Inc.

  • General Acute Care Hospital
  • Douglasville, GA
  • NPI 1649247974
  Care Compare affiliation

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

{
    "created_epoch": "1178496000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1570752000000",
    "number": "1083827232",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8954 HOSPITAL DRIVE",
            "city": "DOUGLASVILLE",
            "state": "GA",
            "postal_code": "30134",
            "telephone_number": "678-838-2585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "677 CHURCH ST NE # 111",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300601101",
            "telephone_number": "770-793-7750"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1365 Clifton Rd NE Ste A4325",
            "address_purpose": "LOCATION",
            "city": "Atlanta",
            "state": "GA",
            "postal_code": "303221013",
            "country_code": "US",
            "telephone_number": "404-778-5334",
            "fax_number": "404-778-5495",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MADDINENI",
        "first_name": "MANOGNA",
        "credential": "M.D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-07",
        "last_updated": "2019-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "GA",
            "license": "06549",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "063369",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mmaddineni67805@directwellstar.org",
            "affiliation": "N",
            "address_1": "677 Church St NE # 111",
            "city": "Marietta",
            "state": "GA",
            "country_code": "US",
            "postal_code": "300601101",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Tisa Macklin
• James Walker Macmahon, RPH
• Sesily Brooke Macon, PHARM. D.
• Macwan Eye Group LLC
• Rima Macwan, O.D.
• Kaitlin Maddox, RBT
• Katrina Nicole Maddox, LPC
• Lavita D Maddox
• Renee R Maddux, PT
• Lori Maenpaa, M.A., CCC-SLP

• Hospitalist Physician in Marietta, GA
• Providers in Marietta, GA by specialty
• Hospitalist Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.