Active NPI
Jared Samuel Friedman, MD
- MOHS-Micrographic Surgery Physician
- Marietta, GA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- MOHS-Micrographic Surgery Physician
- License
- 052722
- Practice address
- 111 Marble Mill Rd NW
Marietta, GA 30060-1047 - Phone
- (770) 422-1013
- Fax
- (770) 514-5996
- NPI assigned
- Apr 26, 2006
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dermatology Physician | 207N00000X | D52722 | GA | |
| MOHS-Micrographic Surgery Physician | 207ND0101X | 052722 | GA | Primary |
Addresses
Primary practice location
111 Marble Mill Rd NW
Marietta, GA 30060-1047
Mailing address
111 Marble Mill Rd NW
Marietta, GA 30060-1047
Phone (770) 422-1013
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| P00145724 | Other | GA | MEDICARE RAILROAD |
| 878435 | Other | GA | BCBS |
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
- Dermatology
- Education
- Medical College of Georgia School of Medicine, 1999
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
111 Marble Mill Rd NW
Marietta, GA 30060-1047
Phone (770) 422-1013
Merit-based Incentive Payment System (MIPS)
- Final score
- 76.76 of 100
- Quality
- 58.29
- Promoting interoperability
- 99
- Improvement activities
- 40
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Melanoma (skin cancer) excision | 268 |
| Removal of skin lesions | 569 |
| Removal of skin cancer | 453 |
| Removal or shaving of skin growth | 1-10 |
| Skin biopsy | 291 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 052722 | GA | MD | Dermatology Physician |
| D52722 | GA | MD | Dermatology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Marietta Dermatology Associates PA | Dermatology | Current | Accepting new patients |
Locations
130 Oakside Ct
Ste A
Canton, GA 30114
Phone (770) 422-1013
840 Church St NE
Ste A1
Marietta, GA 30060
Phone (770) 428-5988
111 Marble Mill Rd NW
Marietta, GA 30060
Phone (770) 422-1013
5041 Dallas Hwy
Ste 209
Powder Springs, GA 30127
Organizations & group practices 1
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.
-
- Dermatology Physician
- Marietta, GA
- NPI 1417007212
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1146009600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1562803200000",
"number": "1316904147",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "111 MARBLE MILL RD NW",
"city": "MARIETTA",
"state": "GA",
"postal_code": "300601047",
"telephone_number": "770-422-1013",
"fax_number": "770-514-5996"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "111 MARBLE MILL RD NW",
"city": "MARIETTA",
"state": "GA",
"postal_code": "300601047",
"telephone_number": "770-422-1013",
"fax_number": "770-514-5996"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FRIEDMAN",
"first_name": "JARED",
"middle_name": "SAMUEL",
"name_prefix": "Mr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-04-26",
"last_updated": "2019-07-11",
"status": "A"
},
"taxonomies": [
{
"code": "207N00000X",
"taxonomy_group": "",
"desc": "Dermatology",
"state": "GA",
"license": "D52722",
"primary": false
},
{
"code": "207ND0101X",
"taxonomy_group": "",
"desc": "Dermatology, MOHS-Micrographic Surgery",
"state": "GA",
"license": "052722",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE RAILROAD",
"identifier": "P00145724",
"state": "GA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "878435",
"state": "GA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Marietta, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2019; 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.