Individual provider Active NPI

Bryan T Kumiga, D.O.

  • Physical Medicine & Rehabilitation Physician
  • Marietta, GA
National Provider Identifier
1255622585
Registry record updated Jul 5, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
078068 Issued in GA
Practice address
300 Tower Rd NE Ste 200
Marietta, GA 30060
Phone
(770) 427-5717
NPI assigned
Apr 20, 2011
Last updated
Jul 5, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 5, 2018

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X 250184 MA
Physical Medicine & Rehabilitation Physician 208100000X 35704 SC
Physical Medicine & Rehabilitation Physician 208100000X 078068 GA Primary
General Practice Physician 208D00000X 254654-1 NY

Addresses

Primary practice location

300 Tower Rd NE Ste 200
Marietta, GA 30060

Mailing address

300 Tower Rd NE Ste 200
Marietta, GA 30060-9403
Phone (770) 427-5717

Other practice location 1

3708 Northside Dr
Macon, GA 31210-2404
Phone (478) 745-4206 ext. 303

Other identifiers 1

IdentifierTypeStateIssuer
300022345AMedicaidGA

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
I20170622001485 GA Practitioner - Physical Medicine and Rehabilitation 1254580178 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and Rehabilitation
Education
New York College of Osteo Medicine of New York Institute of Technology, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Physiotherapy Associates IncGroup PAC ID 3577470442, shared by 50 NPIs, 1,432 clinicians

Practice addresses (Care Compare)

300 Tower Rd NE
Suite 200
Marietta, GA 30060-9403
Phone (770) 427-5717

655 Molly LN
Woodstock, GA 30189-6519
Phone (770) 517-1080

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

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
254654-1NYMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pinnacle Orthopaedics & Sports Medicine Specialists LLC General Practice CurrentSince Jul 9, 2018 Accepting new patients
Pinnacle Orthopaedics & Sports Medicine Specialists LLC Current Accepting new patients
Pinnacle Orthopaedics & Sports Medicine Specialists, LLC Physical Medicine & Rehabilitation CurrentSince Jul 9, 2018 Accepting new patients

Locations

720 Transit Ave
Ste 202
Canton, GA 30114
Phone (770) 345-5717

100 Greystone Power Blvd
Dallas, GA 30157
Phone (678) 453-5717

144 Bill Carruth Pkwy
Ste 4700
Hiram, GA 30141
Phone (678) 453-5717

300 Tower Rd NE
Ste 101
Marietta, GA 30060
Phone (770) 218-0219

300 Tower Rd NE
Ste 170
Marietta, GA 30060

300 Tower Rd NE
Ste 200
Marietta, GA 30060
Phone (770) 427-5717

1505 Stone Bridge Pkwy
Ste 200
Woodstock, GA 30189
Phone (770) 926-6520

Interoperability endpoints

  • Direct secure messaging: bryan.kumiga.1@15749.direct.athenahealth.com
  • Direct secure messaging: bryan.kumiga@po.eclinicaldirectplus.com

Organizations & group practices 3

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.

Hospital & facility affiliations 4

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": "1303257600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1530748800000",
    "number": "1255622585",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 TOWER RD NE STE 200",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300609403",
            "telephone_number": "770-427-5717"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 TOWER RD NE STE 200",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "30060",
            "telephone_number": "770-427-5717"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3708 Northside Dr",
            "address_purpose": "LOCATION",
            "city": "Macon",
            "state": "GA",
            "postal_code": "312102404",
            "country_code": "US",
            "telephone_number": "478-745-4206 x303",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KUMIGA",
        "first_name": "BRYAN",
        "middle_name": "T",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-04-20",
        "last_updated": "2018-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "MA",
            "license": "250184",
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "SC",
            "license": "35704",
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "GA",
            "license": "078068",
            "primary": true
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "NY",
            "license": "254654-1",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300022345A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Marietta, GA

Sources for this page

Verify at the official NPI Registry.