Active NPI
Edwin B Tirado Jr., MD
- Internal Medicine Physician
- Gainesville, GA
National Provider Identifier
1265428312
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 061866
- Practice address
- 1315 Jesse Jewell Pkwy NE
Suite #110
Gainesville, GA 30501-3822 - Phone
- (770) 219-0023
- Fax
- (770) 219-0694
- NPI assigned
- Sep 23, 2005
- Last updated
- Oct 13, 2020
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 061866 | GA | Primary |
Addresses
Primary practice location
1315 Jesse Jewell Pkwy NE
Suite #110
Gainesville, GA 30501-3822
Mailing address
PO Box 742616
Atlanta, GA 30374-2616
Phone (770) 219-8420
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | etirado29378@nghs.gadirect.net | Direct |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Internal Medicine
- Education
- Other, 1997
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
1315 Jesse Jewell Pkwy NE
Suite 110
Gainesville, GA 30501-3822
Phone (770) 219-0023
Hospital & facility affiliations
Merit-based Incentive Payment System (MIPS)
- Final score
- 87.83 of 100
- Quality
- 80.36
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 79.08
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal or shaving of skin growth | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Northeast Georgia Physicians Group Inc | Internal Medicine | Current | Accepting new patients |
| Regional Physician Services, PC | Internal Medicine | Past | Accepting new patients |
Locations
1315 Jesse Jewell Pkwy NE
Ste 110
Gainesville, GA 30501
Phone (770) 219-0023
597 S Enota Dr NE
Gainesville, GA 30501
Phone (770) 219-8275
Interoperability endpoints
- etirado29378@nghs.gadirect.net
- https://api.platform.athenahealth.com/8825/brand/4/csg/1/fhir/r4
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Family Medicine Physician
- Gainesville, GA
- NPI 1891745212
Internal Medicine
-
- Internal Medicine Physician
- Brooklyn, NY
- NPI 1508857343
Hospital & facility affiliations 3
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Gainesville, GA
- NPI 1427055821
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1127433600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1602547200000",
"number": "1265428312",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 742616",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303742616",
"telephone_number": "770-219-8420",
"fax_number": "770-219-8440"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1315 JESSE JEWELL PKWY NE",
"address_2": "SUITE #110",
"city": "GAINESVILLE",
"state": "GA",
"postal_code": "305013822",
"telephone_number": "770-219-0023",
"fax_number": "770-219-0694"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TIRADO",
"first_name": "EDWIN",
"middle_name": "B",
"name_suffix": "Jr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-09-23",
"last_updated": "2020-10-13",
"certification_date": "2020-10-13",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "GA",
"license": "061866",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "etirado29378@nghs.gadirect.net",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"address_1": "1315 Jesse Jewell Pkwy NE",
"address_2": "Suite #110",
"city": "Gainesville",
"state": "GA",
"country_code": "US",
"postal_code": "305013822",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Gainesville, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2020; 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.