Individual provider Active NPI

Peter Kitae Nam, MD

  • Hospitalist Physician
  • Lawrenceville, GA
National Provider Identifier
1154473957
Registry record updated Nov 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
42097 Issued in GA
Practice address
1000 Medical Center Blvd
Lawrenceville, GA 30046-7694
Phone
(678) 312-3273
Fax
(678) 442-3282
NPI assigned
Jan 18, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 16, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 42097 GA
Hospitalist Physician 208M00000X 42097 GA Primary

Addresses

Primary practice location

1000 Medical Center Blvd
Lawrenceville, GA 30046-7694

Mailing address

PO Box 1170
Lawrenceville, GA 30046-1170
Phone (470) 325-0159

Other identifiers 1

IdentifierTypeStateIssuer
000789368FMedicaidGA

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
I20080522000469 GA Practitioner - Hospice/Palliative CarePractitioner - Internal MedicinePractitioner - Hospitalist 1759450364 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Hospice/Palliative CareAlso: Hospitalist, Internal Medicine
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Atlanta Professional Services LLCGroup PAC ID 0840291944, 423 clinicians

Practice addresses (Care Compare)

1000 Medical Ctr Blvd
Lawrenceville, GA 30046-7694
Phone (770) 255-7500

Hospital & facility affiliations

  • Northside Hospital Duluth Hospital, Duluth, GA, CCN 110252
  • Northside Hospital Gwinnett Hospital, Lawrenceville, GA, CCN 110087

Merit-based Incentive Payment System (MIPS)

Final score
98.79 of 100Reported as group
Quality
98.74
Improvement activities
40
Cost
83.11

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
North Atlanta Professional Services LLC Hospitalist CurrentSince Jul 1, 2024 Accepting new patients
24 On Physicians, P.C. Hospitalist CurrentSince Oct 20, 2008 Accepting new patients
Gwinnett Physician Group, LLC Internal Medicine CurrentSince Jul 1, 2008 Accepting new patients
24 On Physicians, PC Hospitalist CurrentSince Oct 20, 2008 Accepting new patients
Wellstar Physicians Group Hospitalists, LLC Internal Medicine Past Accepting new patients
Northside Hospital, Inc. Past Accepting new patients

Locations

13000 Deerfield Pkwy
Ste 100
Alpharetta, GA 30004

1412 Milstead Ave NE
Conyers, GA 30012
Phone (770) 918-3000

1000 Medical Center Blvd
Lawrenceville, GA 30046
Phone (678) 312-3356

11 Upper Riverdale Rd SW
Riverdale, GA 30274
Phone (770) 897-7277

304 Turner McCall Blvd SW
Rome, GA 30165
Phone (706) 506-5000

1000 Johnson Fy Rd NE
Sandy Springs, GA 30342
Phone (404) 851-1000

1000 Johnson Ferry Rd
Sandy Springs, GA 30342
Phone (404) 851-8737

Organizations & group practices 6

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 2

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": "1169078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1542326400000",
    "number": "1154473957",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1170",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300461170",
            "telephone_number": "470-325-0159",
            "fax_number": "470-325-0191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 MEDICAL CENTER BLVD",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300467694",
            "telephone_number": "678-312-3273",
            "fax_number": "678-442-3282"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NAM",
        "first_name": "PETER",
        "middle_name": "KITAE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-18",
        "last_updated": "2018-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "42097",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "GA",
            "license": "42097",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000789368F",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lawrenceville, GA

Sources for this page

Verify at the official NPI Registry.