Individual provider Active NPI

Deborah Ann Kowalchuk, M.D.

  • Orthopaedic Surgery Physician
  • Johns Creek, GA
National Provider Identifier
1245466036
Registry record updated Nov 17, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
073800 Issued in GA
Practice address
6335 Hospital Pkwy
Suite 200
Johns Creek, GA 30097-1549
Phone
(404) 575-4500
Fax
(404) 575-4555
NPI assigned
Jun 8, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2015

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 241059 MA
Orthopaedic Foot and Ankle Surgery Physician 207XX0004X Q0092 TX
Orthopaedic Surgery Physician 207X00000X 073800 GA Primary

Addresses

Primary practice location

6335 Hospital Pkwy
Suite 200
Johns Creek, GA 30097-1549

Mailing address

6335 Hospital Pkwy
Suite 200
Johns Creek, GA 30097-1549
Phone (404) 575-4500

Other identifiers 1

IdentifierTypeStateIssuer
003168359AMedicaidGA

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
I20150728006466 GA Practitioner - Orthopedic Surgery 2264746700 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
University of Pittsburgh School of Medicine, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Resurgens, LLCGroup PAC ID 1153224142, 184 clinicians

Practice addresses (Care Compare)

1285 Hembree Rd
200A
Roswell, GA 30076-4995
Phone (770) 475-2710

270 Chastain NWRD
Kennesaw, GA 30144-3012
Phone (770) 421-8005

4025 Johns Creek Pkwy
Suite 100
Suwanee, GA 30024-1253
Phone (404) 575-4500

5671 Peachtree Dunwoody Rd
Suite 900
Atlanta, GA 30342-5022

5671 Peachtree Dunwoody Rd NE
Suite 900 950
Atlanta, GA 30342-5022
Phone (404) 847-9999

758 Old Norcross Rd
Suite 100
Lawrenceville, GA 30046-3385
Phone (770) 962-4300

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

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hip replacement1-10
Lower limb (leg) arthroscopy (minimally invasive joint repair)1-10
Removal of nail tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
241059MAMDOrthopaedic Surgery Physician
Q0092TXMDOrthopaedic Foot and Ankle Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Resurgens, LLC Orthopaedic Surgery CurrentSince Sep 1, 2015 Accepting new patients
Resurgens, LLC Orthopaedic Surgery CurrentSince Sep 1, 2015 Accepting new patients

Locations

6335 Hospital Pkwy
Ste 200
Johns Creek, GA 30097
Phone (404) 575-4500

1285 Hembree Rd
Ste 200A
Roswell, GA 30076
Phone (770) 475-2710

5671 Ptree Dunwoody Rd NE
Ste 900
Sandy Springs, GA 30342
Phone (404) 531-8590

5671 Ptree Dunwoody Rd NE
Ste 700
Sandy Springs, GA 30342
Phone (404) 459-3732

4025 Johns Creek Pkwy
Ste 100
Suwanee, GA 30024
Phone (404) 575-4500

Interoperability endpoints

  • Direct secure messaging: deborah.kowalchuk.1@15749.direct.athenahealth.com

Organizations & group practices 2

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 3

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": "1244419200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1447718400000",
    "number": "1245466036",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6335 HOSPITAL PKWY",
            "address_2": "SUITE 200",
            "city": "JOHNS CREEK",
            "state": "GA",
            "postal_code": "300971549",
            "telephone_number": "404-575-4500",
            "fax_number": "404-575-4555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6335 HOSPITAL PKWY",
            "address_2": "SUITE 200",
            "city": "JOHNS CREEK",
            "state": "GA",
            "postal_code": "300971549",
            "telephone_number": "404-575-4500",
            "fax_number": "404-575-4555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOWALCHUK",
        "first_name": "DEBORAH",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-08",
        "last_updated": "2015-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "MA",
            "license": "241059",
            "primary": false
        },
        {
            "code": "207XX0004X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Foot and Ankle Surgery",
            "state": "TX",
            "license": "Q0092",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "GA",
            "license": "073800",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003168359A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Johns Creek, GA

Sources for this page

Verify at the official NPI Registry.