Antonio M De la Luz, MD

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

28967 Issued in GA

Practice address

777 Hemlock St
Msc10
Macon, GA 31201-2102

Phone

(478) 633-1146

NPI assigned

Sep 11, 2006

Last updated

Jul 31, 2014By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Emergency Medicine

Education

University Central del Caribe Escuela de Medicina, 1983

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Wellstreet of Georgia PCGroup PAC ID 7517126279, 425 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/14272/brand/70/csg/1/fhir/r4

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.

• Wellstreet of Georgia PC

  dba Piedmont Urgent Care

  • Urgent Care Clinic/Center
  • Newnan, GA
  • NPI 1235411547
  Medicare reassignment Care Compare group NPD
• Central Georgia Emergency Group, LLC

  • Emergency Medicine Physician
  • Macon, GA
  • NPI 1598126641
  Medicare reassignment NPD
• Health Services of Central Georgia, Inc

  dba Atrium Health Navicent Medical Group

  • Multi-Specialty Clinic/Center
  • Macon, GA
  • NPI 1184679482
  NPD (past)
• Swift Emergency Physicians LLC

  • Emergency Medicine Physician
  • Macon, GA
  • NPI 1144467242
  NPD (past)

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

{
    "created_epoch": "1157932800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1406764800000",
    "number": "1275637373",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2490 RIVERSIDE DR",
            "address_2": "STE B",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312041787",
            "telephone_number": "478-633-6633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "777 HEMLOCK ST",
            "address_2": "MSC10",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312012102",
            "telephone_number": "478-633-1146"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DE LA LUZ",
        "first_name": "ANTONIO",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-11",
        "last_updated": "2014-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "GA",
            "license": "28967",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00361391D",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Paul A Davis, CRNA
• Tracy Denise Davis, PA-C
• Alysia-Michelle Dawson, RBT
• Sean Dawson, M.D.
• Igor De Castro, M.D.
• Ricardo Alonso De la Torre Angulo, MD
• Sharon De Neuf, RN
• Davey R Deal Sr., M.D.
• Davey R Deal Jr., M.D.
• Morgan Ashlynn Dean, MA, LPC, NCC

• Emergency Medicine Physician in Macon, GA
• Providers in Macon, GA by specialty
• Emergency Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2014; 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.