Individual provider Active NPI

Michael Levine, MD

  • Gastroenterology Physician
  • Marietta, GA
National Provider Identifier
1154305191
Registry record updated Jul 14, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
12932 Issued in GA
Practice address
2520 Windy Hill Rd SE
Suite 102
Marietta, GA 30067-8664
Phone
(770) 612-8165
Fax
(770) 612-8195
NPI assigned
Dec 2, 2005
Last updated
Jul 14, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2011

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 12932 GA Primary

Addresses

Primary practice location

2520 Windy Hill Rd SE
Suite 102
Marietta, GA 30067-8664

Mailing address

550 Peachtree St NE
Suite 1620
Atlanta, GA 30308-2209
Phone (404) 885-7701

Other identifiers 1

IdentifierTypeStateIssuer
000011261EMedicaidGA

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
I20041027000311 GA Practitioner - Gastroenterology 4486616000 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
Ohio State University College of Medicine, 1968
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Aga, LLCGroup PAC ID 2365431350, 138 clinicians
Aga Professional Services LLCGroup PAC ID 3870768997, 175 clinicians

Practice addresses (Care Compare)

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

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

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
74.39 of 100Reported as group
Quality
44.91
Promoting interoperability
98
Improvement activities
40
Cost
71.38

Procedures performed for Medicare patients

ProcedureNumber of procedures
Upper gastrointestinal (GI) endoscopy for acid reflux25

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Aga Professional Services, LLC Gastroenterology CurrentSince Jan 1, 2012 Accepting new patients
Aga, LLC Gastroenterology CurrentSince Sep 1, 2004 Accepting new patients

Locations

550 Peachtree St NE
Ste 1620
Atlanta, GA 30308
Phone (404) 881-1094

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

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

Interoperability endpoints

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

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 4

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": "1133481600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1310601600000",
    "number": "1154305191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "550 PEACHTREE ST NE",
            "address_2": "SUITE 1620",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303082209",
            "telephone_number": "404-885-7701",
            "fax_number": "404-885-7777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2520 WINDY HILL RD SE",
            "address_2": "SUITE 102",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300678664",
            "telephone_number": "770-612-8165",
            "fax_number": "770-612-8195"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEVINE",
        "first_name": "MICHAEL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-02",
        "last_updated": "2011-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "GA",
            "license": "12932",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000011261E",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Marietta, GA

Sources for this page

Verify at the official NPI Registry.