Individual provider Active NPI

Logan Barrett Dehoff, MD

  • Ophthalmology Physician
  • Canton, GA
National Provider Identifier
1295354025
Registry record updated May 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
99728 Issued in GA
Practice address
201 Kimberly Way Ste 200
Canton, GA 30114-8010
Phone
(678) 381-2020
Fax
(678) 381-2015
NPI assigned
Apr 12, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 10, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Ophthalmology Physician 207W00000X 99728 GA Primary

Addresses

Primary practice location

201 Kimberly Way Ste 200
Canton, GA 30114-8010

Mailing address

1034 Haw Creek Cir Ste 100
Cumming, GA 30041-6513
Phone (678) 381-2020

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
I20240730003414 GA Practitioner - Ophthalmology 1355755992 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
University of Kentucky College of Medicine, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Milan Eye LLCGroup PAC ID 2668519109, 21 clinicians

Practice addresses (Care Compare)

201 Kimberly Way
Suite 200
Canton, GA 30114-8010
Phone (678) 381-2020

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.14 of 100Reported as group
Quality
94
Promoting interoperability
71
Improvement activities
40
Cost
77.3

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery512

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Canton Eye Surgery Center CurrentSince Aug 1, 2024 Accepting new patients
Roswell Eye Surgery Center, LLC CurrentSince Aug 1, 2024 Accepting new patients
Alpharetta Eye Surgery Center LLC CurrentSince Aug 1, 2024 Accepting new patients
Milan Eye LLC Ophthalmology CurrentSince Aug 1, 2024 Accepting new patients
Forsyth Eye Surgery Center, LLC CurrentSince Aug 1, 2024 Accepting new patients
Buford Eye Surgery Center Past Accepting new patients

Locations

2555 Westside Pkwy
Ste 325
Alpharetta, GA 30004

201 Kimberly Way
Ste 200
Canton, GA 30114

201 Kimberly Way
Ste 104
Canton, GA 30114

970 Sanders Rd
Ste 100
Cumming, GA 30041

3775 Roswell Rd
Ste 175
Marietta, GA 30062

1300 Peachtree Industrial
Dallas, TX 75373

Organizations & group practices 6

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": "1586649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715299200000",
    "number": "1295354025",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1034 HAW CREEK CIR STE 100",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "300416513",
            "telephone_number": "678-381-2020",
            "fax_number": "678-381-2015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 KIMBERLY WAY STE 200",
            "city": "CANTON",
            "state": "GA",
            "postal_code": "301148010",
            "telephone_number": "678-381-2020",
            "fax_number": "678-381-2015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEHOFF",
        "first_name": "LOGAN",
        "middle_name": "BARRETT",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-04-12",
        "last_updated": "2024-05-10",
        "certification_date": "2024-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "GA",
            "license": "99728",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Canton, GA

Sources for this page

Verify at the official NPI Registry.