Amr A Agha, M.D.
Individual provider Active NPI Specialist · Douglasville, GA
NPI 1184673238 · NPPES record last updated May 9, 2017
Key facts
- NPI
- 1184673238
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Specialist 174400000X
- License
- 037741 (GA)
- Practice address
- 4904 Timber Ridge Dr
Suite101
Douglasville, GA 30135 - Phone
- (770) 739-7546
- Fax
- (770) 739-7920
- NPI assigned
- May 8, 2006
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare Care Compare profile
- Specialty
- Dermatology
- Education
- Other, 1983
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Advanced Dermatology,P.C.
Practice addresses (Care Compare)
3459 Acworth Due W NWRD
Acworth, GA 30101-5819
Phone (770) 739-7546
Merit-based Incentive Payment System (MIPS)
- Final score
- 75 of 100
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Melanoma (skin cancer) excision | 14 |
| Removal of tissue | 1-10 |
| Removal of skin lesions | 649 |
| Removal of skin cancer | 33 |
| Removal of nail tissue | 1-10 |
| Removal or shaving of skin growth | 1-10 |
| Skin biopsy | 283 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in GA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20050803000572 | GA | Practitioner - Dermatology | 2264460872 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 037741 | GA | MD | Specialist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Advanced Dermatology,P.C. | Specialist | Current |
Accepting new patients |
| Advanced Dermatology at Skincare 5TH Avenue, LLC | Current |
Accepting new patients |
Locations
3459 Acworth Due West Rd NW
Ste 305
Acworth, GA 30101
Phone (770) 739-7546
3459 Acworth Due West Rd NW
Acworth, GA 30101
Phone (678) 521-1105
4904 Timber Ridge Dr
Ste 101
Douglasville, GA 30135
Phone (770) 637-5563
2579 Highway 54
Peachtree Cty, GA 30269
Phone (770) 487-2645
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | 037741 | GA | Yes |
Addresses
Primary practice location
4904 Timber Ridge Dr
Suite101
Douglasville, GA 30135
Mailing address
4904 Timber Ridge Dr
Suite101
Douglasville, GA 30135-1828
Phone (770) 739-7546
Other providers in Douglasville, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 9, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.