Mary Diane Kinsella, M.D.

Primary specialty

Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X

License

64527 Issued in GA

Practice address

1412 Milstead Ave NE Dept of
Conyers, GA 30012

Phone

(678) 423-1550

Fax

(678) 423-1550

NPI assigned

Dec 20, 2007

Last updated

Aug 10, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Mary Diane Darrow Former name

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

Specialty

Pathology

Education

University of North Carolina at Chapel Hill School of Medicine, 2007

Medicare assignment

May accept Medicare assignment

Group practices

Pathology and Laboratory Medicine, PCGroup PAC ID 1254323991, 26 clinicians

South Suburban Pathologists PCGroup PAC ID 0547254872, 8 clinicians

Gastrointestinal Specialist of GeorgiaGroup PAC ID 9335032820, 35 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Northside Hospital Hospital, Atlanta, GA, CCN 110161

Merit-based Incentive Payment System (MIPS)

Final score

87.78 of 100Reported as group

Quality

85.63

Improvement activities

40

Merit-based Incentive Payment System (MIPS)

Final score

93.93 of 100Reported as apm

Quality

82.14

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Gastrointestinal Specialist of Georgia

  • Gastroenterology Physician
  • Marietta, GA
  • NPI 1801975339
  Medicare reassignment Care Compare group NPD
• Pathology and Laboratory Medicine, PC

  • Anatomic Pathology & Clinical Pathology Physician
  • Atlanta, GA
  • NPI 1649494816
  Medicare reassignment Care Compare group NPD
• South Suburban Pathologists PC

  • Anatomic Pathology & Clinical Pathology Physician
  • Conyers, GA
  • NPI 1720016801
  Medicare reassignment Care Compare group NPD
• City of Hope Medical Group of Georgia LLC

  • Internal Medicine Physician
  • Newnan, GA
  • NPI 1447520333
  Medicare reassignment NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Northside Hospital, Inc.

  dba Northside Hospital

  • General Acute Care Hospital
  • Atlanta, GA
  • NPI 1457396079
  Care Compare affiliation

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

{
    "created_epoch": "1198108800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691625600000",
    "number": "1205010790",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5700 SOUTHWYCK BLVD",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436141509",
            "telephone_number": "800-288-8325",
            "fax_number": "419-866-5453"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1412 MILSTEAD AVE NE DEPT OF",
            "city": "CONYERS",
            "state": "GA",
            "postal_code": "30012",
            "telephone_number": "678-423-1550",
            "fax_number": "678-423-1550"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11 Upper Riverdale Rd SW",
            "address_2": "Southern Regional Hospital-Department of Pathology",
            "address_purpose": "LOCATION",
            "city": "Riverdale",
            "state": "GA",
            "postal_code": "30274",
            "country_code": "US",
            "telephone_number": "678-423-1550",
            "fax_number": "678-423-1550",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KINSELLA",
        "first_name": "MARY",
        "middle_name": "DIANE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-12-20",
        "last_updated": "2023-08-10",
        "certification_date": "2023-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "GA",
            "license": "002586",
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "GA",
            "license": "64527",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARY",
            "last_name": "DARROW",
            "middle_name": "DIANE",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Elyssia King, PT
• Marvin Brien King
• Steven P King, DDS
• Ganesh N Kini, MD
• Jason Kinkartz, MD
• Ted M Kirk, SOCIAL WORKER
• Sarah Kirkpatrick, M. ED., CCC-SLP
• Annmarie Suzette Klein, RD
• Lindsey Klein, PTA
• Tania A. Klubenspies, D.C.

• Anatomic Pathology & Clinical Pathology Physician in Conyers, GA
• Providers in Conyers, GA by specialty
• Anatomic Pathology & Clinical Pathology Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.