Individual provider Active NPI

Allison Rogers Paine, MD

  • Dermatology Physician
  • Martinez, GA
National Provider Identifier
1104212612
Registry record updated May 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
MT209874 Issued in PA
Practice address
575 Furys Ferry Rd
Martinez, GA 30907-9059
Phone
(706) 691-7079
Fax
(706) 364-0416
NPI assigned
Apr 10, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 24, 2023

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 83220 GA
MOHS-Micrographic Surgery Physician 207ND0101X 83220 GA
Student in an Organized Health Care Education/Training Program 390200000X
Dermatology Physician 207N00000X MT209874 PA Primary

Addresses

Primary practice location

575 Furys Ferry Rd
Martinez, GA 30907-9059

Mailing address

575 Furys Ferry Rd
Martinez, GA 30907-9059
Phone (706) 691-7079

Other identifiers 1

IdentifierTypeStateIssuer
MT209874OtherPENNSYLVANIA TRAINING LISCENCE

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
I20190722001111 GA Practitioner - Dermatology 4284914730 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Medical College of Georgia School of Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Savannah River Dermatology LLCGroup PAC ID 5597824789, 7 clinicians

Practice addresses (Care Compare)

575 Furys Ferry Rd
Martinez, GA 30907-9059
Phone (706) 691-7079

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision144
Removal of tissue1-10
Removal of skin lesions537
Removal of skin cancer646
Removal of nail tissue1-10
Removal or shaving of skin growth1-10
Skin biopsy241

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Savannah River Dermatology LLC CurrentSince Aug 1, 2019 Accepting new patients

Locations

575 Furys Ferry Rd
Martinez, GA 30907
Phone (706) 691-7079

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
  • Direct secure messaging: allison.painemd.p53@direct.savannahriverderm.nextgenshare.com

Organizations & group practices 1

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 1

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": "1428624000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684886400000",
    "number": "1104212612",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "575 FURYS FERRY RD",
            "city": "MARTINEZ",
            "state": "GA",
            "postal_code": "309079059",
            "telephone_number": "706-691-7079",
            "fax_number": "706-364-0416"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "575 FURYS FERRY RD",
            "city": "MARTINEZ",
            "state": "GA",
            "postal_code": "309079059",
            "telephone_number": "706-691-7079",
            "fax_number": "706-364-0416"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAINE",
        "first_name": "ALLISON",
        "middle_name": "ROGERS",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-10",
        "last_updated": "2023-05-24",
        "certification_date": "2023-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "GA",
            "license": "83220",
            "primary": false
        },
        {
            "code": "207ND0101X",
            "taxonomy_group": "",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "GA",
            "license": "83220",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "PA",
            "license": "MT209874",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PENNSYLVANIA TRAINING LISCENCE",
            "identifier": "MT209874",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Martinez, GA

Sources for this page

Verify at the official NPI Registry.