Individual provider Active NPI

Jing Feng Gill, MD

  • MOHS-Micrographic Surgery Physician
  • Lawrenceville, GA
National Provider Identifier
1164531166
Registry record updated Oct 31, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
MOHS-Micrographic Surgery PhysicianTaxonomy code 207ND0101X
License
67421 Issued in GA
Practice address
771 Old Norcross Rd
Suite 260
Lawrenceville, GA 30046-4386
Phone
(770) 962-5040
Fax
(770) 962-5056
NPI assigned
Aug 30, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2012

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X ML20008479 WA
Dermatology Physician 207N00000X MD.202777 LA
Dermatology Physician 207N00000X 202777 LA
MOHS-Micrographic Surgery Physician 207ND0101X A115940 CA
MOHS-Micrographic Surgery Physician 207ND0101X 67421 GA Primary

Addresses

Primary practice location

771 Old Norcross Rd
Suite 260
Lawrenceville, GA 30046-4386

Mailing address

771 Old Norcross Rd
Suite 260
Lawrenceville, GA 30046-4386
Phone (770) 962-5040

Other names 1

  • Jing Feng Former name

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
I20120731000291 GA Practitioner - DermatologyPractitioner - Micrographic Dermatologic Surgery (MDS) 0840342929 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
DermatologyAlso: Micrographic Dermatologic Surgery (MDS)
Education
Yale University School of Medicine, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Advanced Dermatology of Georgia, LLCGroup PAC ID 9638485782, 15 clinicians

Practice addresses (Care Compare)

771 Old Norcross Rd
Suite 260
Lawrenceville, GA 30046-4981
Phone (770) 962-5040

Merit-based Incentive Payment System (MIPS)

Final score
94.02 of 100Reported as group
Quality
88.03
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision179
Removal of tissue1-10
Removal of skin lesions22
Removal of skin cancer892
Skin biopsy44

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD.202777LAMDDermatology Physician
ML20008479WAMDDermatology Physician
A115940CAMDMOHS-Micrographic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Dermatology of Georgia, LLC Dermatology CurrentSince Oct 1, 2015 Accepting new patients

Locations

151 Southhall Ln
Ste 300
Maitland, FL 32751
Phone (407) 917-7293

2709 Meredyth Dr
Ste 340
Albany, GA 31707
Phone (229) 882-1130

771 Old Norcross Rd
Ste 260
Lawrenceville, GA 30046
Phone (770) 962-5040

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 and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1351641600000",
    "number": "1164531166",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "771 OLD NORCROSS RD",
            "address_2": "SUITE 260",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300464386",
            "telephone_number": "770-962-5040",
            "fax_number": "770-962-5056"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "771 OLD NORCROSS RD",
            "address_2": "SUITE 260",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300464386",
            "telephone_number": "770-962-5040",
            "fax_number": "770-962-5056"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILL",
        "first_name": "JING",
        "middle_name": "FENG",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-30",
        "last_updated": "2012-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "WA",
            "license": "ML20008479",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "LA",
            "license": "MD.202777",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "LA",
            "license": "202777",
            "primary": false
        },
        {
            "code": "207ND0101X",
            "taxonomy_group": "",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "CA",
            "license": "A115940",
            "primary": false
        },
        {
            "code": "207ND0101X",
            "taxonomy_group": "",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "GA",
            "license": "67421",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JING",
            "last_name": "FENG",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Lawrenceville, GA

Sources for this page

Verify at the official NPI Registry.