NPIMap

Individual provider Active NPI

Bram Wieskopf, MD

  • Internal Medicine Physician
  • Woodstock, GA
National Provider Identifier
1164472577
Registry record updated Mar 4, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
045136 Issued in GA
Practice address
1192 Buckhead Xing
Suite E
Woodstock, GA 30189-4254
Phone
(678) 494-4450
Fax
(678) 494-6265
NPI assigned
May 10, 2006
Last updated
Mar 4, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2008

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 045136 GA Primary

Addresses

Primary practice location

1192 Buckhead Xing
Suite E
Woodstock, GA 30189-4254

Mailing address

1192 Buckhead Xing
Suite E
Woodstock, GA 30189-4254
Phone (678) 494-4450

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
I20101122001241 GA Practitioner - Internal Medicine 5698767150 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1192 Buckhead Xing
Suite E
Woodstock, GA 30189-4255
Phone (678) 494-4450

Hospital & facility affiliations

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
045136GAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
North Georgia Internal Medicine, PC Internal Medicine CurrentSince Sep 1, 2002 Accepting new patients

Locations

1192 Buckhead Xing
Ste E
Woodstock, GA 30189
Phone (678) 494-4450

Interoperability endpoints

  • Direct secure messaging: bram.wieskopf.1@20065.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/20065/brand/1/csg/1/fhir/r4

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 6

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": "1147219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1204588800000",
    "number": "1164472577",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1192 BUCKHEAD XING",
            "address_2": "SUITE E",
            "city": "WOODSTOCK",
            "state": "GA",
            "postal_code": "301894254",
            "telephone_number": "678-494-4450",
            "fax_number": "678-494-6265"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1192 BUCKHEAD XING",
            "address_2": "SUITE E",
            "city": "WOODSTOCK",
            "state": "GA",
            "postal_code": "301894254",
            "telephone_number": "678-494-4450",
            "fax_number": "678-494-6265"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIESKOPF",
        "first_name": "BRAM",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-10",
        "last_updated": "2008-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "045136",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodstock, GA

Sources for this page

Verify at the official NPI Registry.