NPIMap

Individual provider Active NPI

Stanley R Mogelnicki, MD

  • Internal Medicine Physician
  • Woodstock, GA
National Provider Identifier
1164411385
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
046459 Issued in GA
Practice address
145 N Medical Pkwy
Woodstock, GA 30189-7031
Phone
(770) 592-3000
Fax
(770) 592-3012
NPI assigned
Oct 20, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 046459 GA Primary

Addresses

Primary practice location

145 N Medical Pkwy
Woodstock, GA 30189-7031

Mailing address

145 N Medical Pkwy
Woodstock, GA 30189-7031
Phone (770) 592-3000

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080424000411 GA Practitioner - Internal Medicine 1759469273 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Medical College of Georgia School of Medicine, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Wellstar Medical Group LLCGroup PAC ID 6709065402, 3,059 clinicians

Practice addresses (Care Compare)

145 N Medical Pkwy
Woodstock, GA 30189-7031
Phone (770) 592-3000

Hospital & facility affiliations

  • Community Home Health, an Amedisys Company Home health agency, Woodstock, GA, CCN 117130
  • Wellstar Home Health, LLC Home health agency, Marietta, GA, CCN 117102
  • Accentcare Home Health of Georgia Home health agency, Roswell, GA, CCN 117131
  • Amedisys Northwest Home Health Home health agency, Jasper, GA, CCN 117064
  • Centerwell Home Health Home health agency, Cumming, GA, CCN 117136
  • Wellstar Kennestone Regional Medical Center Hospital, Marietta, GA, CCN 110035
  • Wellstar Cobb Medical Center Hospital, Austell, GA, CCN 110143
  • Northside Hospital Cherokee Hospital, Canton, GA, CCN 110008
  • Wellstar North Fulton Medical Center Hospital, Roswell, GA, CCN 110198
  • Wellstar Paulding Medical Center Hospital, Hiram, GA, CCN 110042
  • Wellstar Windy Hill Hospital Long-term care hospital, Marietta, GA, CCN 112007

Merit-based Incentive Payment System (MIPS)

Final score
93.93 of 100Reported as apm
Quality
82.14
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
046459GAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wellstar Medical Group, LLC CurrentSince Mar 1, 2011 Accepting new patients
Wellstar Medical Group, LLC CurrentSince Mar 1, 2011 Accepting new patients
Wellstar Medical Group, LLC Current Accepting new patients
Wellstar Medical Group, LLC Internal Medicine Past Accepting new patients
Wellstar Cardiovascular Medicine, LLC Past Accepting new patients

Locations

5150 Stilesboro Rd NW
Ste 120
Kennesaw, GA 30152
Phone (678) 354-0230

5150 Stilesboro Rd NW
Ste 220
Kennesaw, GA 30152
Phone (770) 424-8222

145 N Medical Pkwy
Woodstock, GA 30189
Phone (770) 517-1900

Interoperability endpoints

  • Direct secure messaging: smogelnicki9904@directwellstar.org

Organizations & group practices 5

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 11

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": "1129766400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1164411385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "145 N MEDICAL PKWY",
            "city": "WOODSTOCK",
            "state": "GA",
            "postal_code": "301897031",
            "telephone_number": "770-592-3000",
            "fax_number": "770-592-3012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "145 N MEDICAL PKWY",
            "city": "WOODSTOCK",
            "state": "GA",
            "postal_code": "301897031",
            "telephone_number": "770-592-3000",
            "fax_number": "770-592-3012"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOGELNICKI",
        "first_name": "STANLEY",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "046459",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodstock, GA

Sources for this page

Verify at the official NPI Registry.