Individual provider Active NPI

Jose L. Fernandez-Gerena, MD

  • Surgery Physician
  • Stockbridge, GA
National Provider Identifier
1285921171
Registry record updated Jul 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
075622 Issued in GA
Practice address
1040 Eagles Landing Parkway
Suite 100
Stockbridge, GA 30281-9073
Phone
(770) 474-7287
Fax
(770) 389-3713
NPI assigned
Jun 30, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 30, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 4301099137 MI
Surgery Physician 208600000X 075622 GA Primary

Addresses

Primary practice location

1040 Eagles Landing Parkway
Suite 100
Stockbridge, GA 30281-9073

Mailing address

1040 Eagles Landing Parkway
Suite 100
Stockbridge, GA 30281-9073
Phone (770) 474-7287

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
I20161228002445 GA Practitioner - General Surgery 2961783295 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
University of Puerto Rico School of Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Surgery South PCGroup PAC ID 5991786725, 4 clinicians

Practice addresses (Care Compare)

1040 Eagle Lndng Pkwy
Suite 100
Stockbridge, GA 30281-9073
Phone (770) 474-7287

Hospital & facility affiliations

  • Piedmont Henry Hospital Hospital, Stockbridge, GA, CCN 110191

Merit-based Incentive Payment System (MIPS)

Final score
83.81 of 100Reported as group
Quality
56.68
Promoting interoperability
100
Improvement activities
40
Cost
74.54

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hernia repair (minimally invasive)1-10
Upper gastrointestinal (GI) endoscopy for acid reflux1-10
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
075622GAMDSurgery Physician
4301099137MIMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Emory Medical Care Foundation Inc CurrentSince Aug 1, 2016 Accepting new patients
Emory Medical Care Foundation Inc Surgery Current Accepting new patients
Emory Medical Care Foundation Surgery CurrentSince Aug 1, 2016 Accepting new patients
Surgery South PC Surgery CurrentSince Sep 19, 2017 Accepting new patients
Acute Care Surgery Medical Group, Inc. Surgery CurrentSince Jul 15, 2023 Accepting new patients

Locations

80 Jesse Hill Jr Dr SE
Atlanta, GA 30303
Phone (404) 616-4370

150 Eagle Spring Ct
Ste A
Stockbridge, GA 30281
Phone (404) 299-3338

1133 Eagles Landing Pkwy
Stockbridge, GA 30281
Phone (678) 604-1000

1040 Eagles Landing Pkwy
Ste 100
Stockbridge, GA 30281
Phone (770) 474-7287

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": "1309392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596067200000",
    "number": "1285921171",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1040 EAGLES LANDING PARKWAY",
            "address_2": "SUITE 100",
            "city": "STOCKBRIDGE",
            "state": "GA",
            "postal_code": "302819073",
            "telephone_number": "770-474-7287",
            "fax_number": "770-389-3713"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1040 EAGLES LANDING PARKWAY",
            "address_2": "SUITE 100",
            "city": "STOCKBRIDGE",
            "state": "GA",
            "postal_code": "302819073",
            "telephone_number": "770-474-7287",
            "fax_number": "770-389-3713"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FERNANDEZ-GERENA",
        "first_name": "JOSE",
        "middle_name": "L.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-06-30",
        "last_updated": "2020-07-30",
        "certification_date": "2020-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MI",
            "license": "4301099137",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "GA",
            "license": "075622",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stockbridge, GA

Sources for this page

Verify at the official NPI Registry.