NPIMap

Individual provider Active NPI

Andrew Thomas Tkaczuk, M.D.

  • Otolaryngology Physician
  • Atlanta, GA
National Provider Identifier
1154663748
Registry record updated Aug 27, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
79944 Issued in GA
Practice address
550 Peachtree St NE FL 9
Atlanta, GA 30308
Phone
(404) 778-3381
NPI assigned
Mar 21, 2013
Last updated
Aug 27, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X 79944 GA Primary

Addresses

Primary practice location

550 Peachtree St NE FL 9
Atlanta, GA 30308

Mailing address

510 E Ponce de Leon Ave Apt C
Decatur, GA 30030-1971
Phone (443) 538-3769

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, SC2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20180817002136 GA Practitioner - Otolaryngology 6103124540 Reassigns benefits to 3 organizations
I20250708002750 SC Practitioner - Otolaryngology 6103124540 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
University of Maryland School of Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Augusta ENT PCGroup PAC ID 9537156484, shared by 2 NPIs, 24 clinicians

Practice addresses (Care Compare)

170 University Pkwy
Aiken, SC 29801-6308
Phone (706) 868-5676

340 N Belair Rd
Evans, GA 30809-3000
Phone (706) 868-5676

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.24 of 100Reported as group
Quality
73.72
Promoting interoperability
100
Improvement activities
40
Cost
75.22

Merit-based Incentive Payment System (MIPS)

Final score
94.51 of 100Reported as apm
Quality
80.61
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Upper gastrointestinal (GI) endoscopy for acid reflux1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
79944GAMDOtolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Emory Medical Care Foundation Inc Current Accepting new patients
Emory Medical Care Foundation Inc CurrentSince Jul 6, 2018 Accepting new patients
The Emory Clinic Inc CurrentSince Jul 6, 2018 Accepting new patients
Augusta ENT PC Otolaryngology CurrentSince Jun 1, 2025 Accepting new patients
Augusta ENT PC CurrentSince Jun 1, 2025 Accepting new patients
Emory Medical Care Foundation Otolaryngology CurrentSince Jul 6, 2018 Accepting new patients
Emory Health Care Past Accepting new patients
The Emory Clinic Pediatric Providers Past Accepting new patients

Locations

1365 Clifton Rd NE
Atlanta, GA 30322
Phone (404) 778-7525

550 Peachtree St NE
Fl 9
Atlanta, GA 30308
Phone (404) 686-1850

80 Jesse Hill Jr Dr SE
Atlanta, GA 30303
Phone (404) 616-4370

720 Saint Sebastian Way
Ste 201
Augusta, GA 30901
Phone (478) 746-7577

804 Scott Nixon Memorial Dr
#D
Augusta, GA 30907

340 N Belair Rd
Evans, GA 30809
Phone 7068685676650

4975 Gateway Blvd
Grovetown, GA 30813

804 Scott Nixon Memorial Dr
Martinez, GA 30907

170 University Pkwy
Aiken, SC 29801
Phone (803) 649-9975

Interoperability endpoints

  • Direct secure messaging: atkaczuk56080@direct.emory.org

Organizations & group practices 8

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 5

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": "1363824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1535328000000",
    "number": "1154663748",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "510 E PONCE DE LEON AVE APT C",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300301971",
            "telephone_number": "443-538-3769"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 PEACHTREE ST NE FL 9",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "30308",
            "telephone_number": "404-778-3381"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TKACZUK",
        "first_name": "ANDREW",
        "middle_name": "THOMAS",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-03-21",
        "last_updated": "2018-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "GA",
            "license": "79944",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.