Individual provider Active NPI

Dingane Baruti, M.D

  • Family Medicine Physician
  • Douglasville, GA
National Provider Identifier
1215945969
Registry record updated Oct 4, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
055411 Issued in GA
Practice address
6842 Douglas Blvd Ste K
Douglasville, GA 30135
Phone
(404) 937-3508
NPI assigned
Aug 4, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 055411 GA Primary

Addresses

Primary practice location

6842 Douglas Blvd Ste K
Douglasville, GA 30135

Mailing address

6842 Douglas Blvd Ste K
Douglasville, GA 30135-1576
Phone (404) 937-3508

Other practice location 1

406 W 5th St
Ocilla, GA 31774-1421
Phone (229) 468-9166

Other identifiers 1

IdentifierTypeStateIssuer
003132308AMedicaidGA

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
I20111019000841 GA Practitioner - Family Practice 4486826286 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southland Dodge Emergency Medical Services, LLCGroup PAC ID 8224360805, 12 clinicians

Practice addresses (Care Compare)

901 Griffin Ave
Eastman, GA 31023-6720
Phone (478) 448-4000

Hospital & facility affiliations

  • Dodge County Hospital Hospital, Eastman, GA, CCN 110092

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
055411GAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
My Online Doctor'S Visit LLC Family Medicine CurrentSince May 31, 2023 Accepting new patients
Southland Dodge Emergency Medical Services, LLC CurrentSince Oct 19, 2019 Accepting new patients
Southland Consolidated Emergency Services, LLC CurrentSince Jan 20, 2020 Accepting new patients
Hospital Authority of the City of Bainbridge and Decatur County Past Accepting new patients
Jorge a. Bueno Chiropractic LLC Past Accepting new patients

Locations

1500 E Shotwell St
Bainbridge, GA 39819
Phone (229) 243-6100

901 Griffin Ave
Eastman, GA 31023
Phone (478) 374-4000

4 Medical Dr
Elberton, GA 30635
Phone (706) 213-2527

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 1

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": "1154649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1570147200000",
    "number": "1215945969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6842 DOUGLAS BLVD STE K",
            "city": "DOUGLASVILLE",
            "state": "GA",
            "postal_code": "301351576",
            "telephone_number": "404-937-3508",
            "fax_number": "404-973-2004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6842 DOUGLAS BLVD STE K",
            "city": "DOUGLASVILLE",
            "state": "GA",
            "postal_code": "30135",
            "telephone_number": "404-937-3508"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "406 W 5th St",
            "address_purpose": "LOCATION",
            "city": "Ocilla",
            "state": "GA",
            "postal_code": "317741421",
            "country_code": "US",
            "telephone_number": "229-468-9166",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BARUTI",
        "first_name": "DINGANE",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-04",
        "last_updated": "2019-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "055411",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003132308A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Douglasville, GA

Sources for this page

Verify at the official NPI Registry.