Individual provider Active NPI

Thomas Elliot Edwards Jr., M.D.

  • Specialist
  • Decatur, GA
National Provider Identifier
1326029125
Registry record updated May 31, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
038743 Issued in GA
Practice address
2799 Lawrenceville Hwy
Suite 104
Decatur, GA 30033-2531
Phone
(678) 534-0200
Fax
(678) 534-0201
NPI assigned
Nov 9, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 31, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 038743 GA Primary

Addresses

Primary practice location

2799 Lawrenceville Hwy
Suite 104
Decatur, GA 30033-2531

Mailing address

2799 Lawrenceville Hwy
Suite 104
Decatur, GA 30033-2531
Phone (678) 534-0200

Other identifiers 1

IdentifierTypeStateIssuer
000613082DMedicaidGA

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
I20110419000484 GA Practitioner - Ophthalmology 7911919279 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
University of North Carolina at Chapel Hill School of Medicine, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1100 Johnson Ferry Rd
Suite 105
Atlanta, GA 30342-1733
Phone (404) 531-9988

550 Peachtree St NE
Suite 1500
Atlanta, GA 30308-2248
Phone (404) 897-6810

Merit-based Incentive Payment System (MIPS)

Final score
94.51 of 100Reported as apm
Quality
80.61
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Eugene B Gabianelli MD & Assoc LLC CurrentSince Apr 5, 2021 Accepting new patients
Eugene B. Gabianelli, MD & Assoc. LLC CurrentSince Apr 5, 2021 Accepting new patients

Locations

550 Peachtree St NE
Ste 1500
Atlanta, GA 30308
Phone (404) 897-6710

2799 Lawrenceville Hwy
Ste 104
Decatur, GA 30033
Phone (404) 297-3440

1100 Johnson Fy Rd NE
Ste 108
Sandy Springs, GA 30342
Phone (404) 531-9988

500 Ross St
#15404
Pittsburgh, PA 15262

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1131494400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1306800000000",
    "number": "1326029125",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2799 LAWRENCEVILLE HWY",
            "address_2": "SUITE 104",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300332531",
            "telephone_number": "678-534-0200",
            "fax_number": "678-534-0201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2799 LAWRENCEVILLE HWY",
            "address_2": "SUITE 104",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300332531",
            "telephone_number": "678-534-0200",
            "fax_number": "678-534-0201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDWARDS",
        "first_name": "THOMAS",
        "middle_name": "ELLIOT",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-11-09",
        "last_updated": "2011-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "GA",
            "license": "038743",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000613082D",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Decatur, GA

Sources for this page

Verify at the official NPI Registry.