Individual provider Active NPI

Bruce Terence Kalmin, MD

  • Gastroenterology Physician
  • Canton, GA
National Provider Identifier
1093805509
Registry record updated Aug 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
54441 Issued in GA
Practice address
2020 Cumming Hwy Ste 102
Canton, GA 30115-8071
Phone
(678) 593-1295
Fax
(678) 593-1294
NPI assigned
Oct 13, 2006
Last updated
Aug 15, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 54441 GA Primary

Addresses

Primary practice location

2020 Cumming Hwy Ste 102
Canton, GA 30115-8071

Mailing address

2020 Cumming Hwy Ste 102
Canton, GA 30115-8071
Phone (678) 593-1295

Other identifiers 2

IdentifierTypeStateIssuer
667854561GMedicaidGA
202I117290OtherGAMEDICARE PTAN

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
I20050829000422 GA Practitioner - GastroenterologyPractitioner - Internal Medicine 1355372426 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
GastroenterologyAlso: Internal Medicine
Education
University of Texas Medical School at San Antonio, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aga, LLCGroup PAC ID 2365431350, 138 clinicians
Aga Professional Services LLCGroup PAC ID 3870768997, 175 clinicians

Practice addresses (Care Compare)

1000 Johnson Ferry Rd
Atlanta, GA 30342-1606

2020 Cumming Hwy
Suite 102
Canton, GA 30115-8071
Phone (678) 593-1295

2520 Windy Hill Rd SE
Suite 102
Marietta, GA 30067-8633
Phone (770) 612-8165

450 Northside Cherokee Blvd
Canton, GA 30115-8015
Phone (770) 224-1000

488 Kennesaw Ave NW
Suite 200
Marietta, GA 30060-9409
Phone (770) 427-3075

900 Towne Lake Pkwy
Suite 308
Woodstock, GA 30189-1604
Phone (770) 926-5459

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy148
Upper gastrointestinal (GI) endoscopy for acid reflux214

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
54441GAMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Aga Professional Services, LLC Gastroenterology CurrentSince Jan 1, 2012 Accepting new patients
Aga, LLC Gastroenterology CurrentSince Aug 1, 2009 Accepting new patients

Locations

550 Peachtree St NE
Ste 1600
Atlanta, GA 30308
Phone (404) 881-1094

218 Hospital Dr
#C
Blairsville, GA 30512
Phone (706) 400-5668

2020 Cumming Hwy
#102
Canton, GA 30115
Phone (678) 593-1295

320 Hospital Rd
Ste 320
Canton, GA 30114
Phone (678) 593-1294

320 Hospital Rd
Ste 320B
Canton, GA 30114
Phone (678) 593-1294

2520 Windy Hill Rd SE
Ste 102
Marietta, GA 30067
Phone (770) 612-8165

488 Kennesaw Ave NW
Ste 150
Marietta, GA 30060
Phone (770) 427-3075

488 Kennesaw Ave NW
Ste 200
Marietta, GA 30060
Phone (770) 427-3075

2401 Newnan Crossing Blvd E
Ste 110
Newnan, GA 30265
Phone (678) 631-4610

5671 Peachtree Dunwoody Rd
Ste 511
Sandy Springs, GA 30342

5671 Peachtree Dunwoody Rd
Ste 600
Sandy Springs, GA 30342
Phone (404) 252-9307

900 Towne Lake Pkwy
Ste 308
Woodstock, GA 30189
Phone (770) 926-5459

Interoperability endpoints

  • Direct secure messaging: bruce.kalmin@ud.eclinicaldirectplus.com
  • FHIR API: https://fhir-myrecord.cerner.com/r4/d88010de-d791-42d4-b72d-513f9afc5ed1/

Organizations & group practices 2

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 3

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": "1160697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723680000000",
    "number": "1093805509",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2020 CUMMING HWY STE 102",
            "city": "CANTON",
            "state": "GA",
            "postal_code": "301158071",
            "telephone_number": "678-593-1295",
            "fax_number": "678-593-1294"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2020 CUMMING HWY STE 102",
            "city": "CANTON",
            "state": "GA",
            "postal_code": "301158071",
            "telephone_number": "678-593-1295",
            "fax_number": "678-593-1294"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KALMIN",
        "first_name": "BRUCE",
        "middle_name": "TERENCE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-13",
        "last_updated": "2024-08-15",
        "certification_date": "2024-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "GA",
            "license": "54441",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "667854561G",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "202I117290",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Canton, GA

Sources for this page

Verify at the official NPI Registry.