Roosevelt Allen, M.D.

Primary specialty

Urology PhysicianTaxonomy code 208800000X

License

036083 Issued in GA

Practice address

500 Medical Center Blvd
Suite 220
Lawrenceville, GA 30046

Phone

(770) 963-2451

Fax

(770) 962-0017

NPI assigned

Aug 13, 2006

Last updated

Mar 7, 2023By 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

Electronic endpoints 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

Urology

Education

Medical College of Georgia School of Medicine, 1987

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Georgia Urology, PAGroup PAC ID 8921094376, 99 clinicians

Urological Professional Services, LLCGroup PAC ID 9638391717, 72 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Northside Hospital Gwinnett Hospital, Lawrenceville, GA, CCN 110087
• Northside Hospital Hospital, Atlanta, GA, CCN 110161
• Piedmont Walton Hospital Hospital, Monroe, GA, CCN 110046
• Piedmont Eastside Medical Center Hospital, Snellville, GA, CCN 110192
• Northside Hospital Forsyth Hospital, Cumming, GA, CCN 110005

Merit-based Incentive Payment System (MIPS)

Final score

78.21 of 100Reported as group

Quality

52.19

Promoting interoperability

98

Improvement activities

40

Cost

76.84

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
• Direct secure messaging: roosevelt.allen.p1@direct.gupa.nextgenshare.com
• Direct secure messaging: roosevelt.allen@gadirect.net

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.

• Georgia Urology PA

  • Urology Physician
  • Riverdale, GA
  • NPI 1245250646
  Medicare reassignment Care Compare group NPD
• Urological Professional Services, LLC

  • Urology Physician
  • Atlanta, GA
  • NPI 1033521810
  Medicare reassignment Care Compare group NPD
• Georgia Urology PA

  • Urology Physician
  • Fayetteville, GA
  • NPI 1407194558
  NPD
• Georgia Urology, PA

  • Ambulatory Surgical Clinic/Center
  • Braselton, GA
  • NPI 1861222119
  NPD
• Georgia Urology PA

  • Urology Physician
  • Lawrenceville, GA
  • NPI 1053536243
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Eastside Medical Center, LLC

  dba Piedmont Eastside Medical Center

  • General Acute Care Hospital
  • Snellville, GA
  • NPI 1467406132
  Care Compare affiliation
• Northside Hospital, Inc.

  dba Northside Hospital Forsyth

  • General Acute Care Hospital
  • Cumming, GA
  • NPI 1376574277
  Care Compare affiliation
• Northside Hospital, Inc.

  dba Northside Hospital

  • General Acute Care Hospital
  • Atlanta, GA
  • NPI 1457396079
  Care Compare affiliation
• Northside Hospital, Inc.

  dba Northside Hospital Gwinnett

  • General Acute Care Hospital
  • Lawrenceville, GA
  • NPI 1952340994
  Care Compare affiliation
• Piedmont Walton Hospital Inc

  • General Acute Care Hospital
  • Monroe, GA
  • NPI 1720589328
  Care Compare affiliation

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

{
    "created_epoch": "1155427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1326050485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1930 BRANNAN RD",
            "city": "MCDONOUGH",
            "state": "GA",
            "postal_code": "302534310",
            "telephone_number": "678-284-4040",
            "fax_number": "678-284-4076"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 MEDICAL CENTER BLVD",
            "address_2": "SUITE 220",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "30046",
            "telephone_number": "770-963-2451",
            "fax_number": "770-962-0017"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALLEN",
        "first_name": "ROOSEVELT",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-13",
        "last_updated": "2023-03-07",
        "certification_date": "2020-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "GA",
            "license": "036083",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "340015405",
            "state": "GA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "roosevelt.allen.p1@direct.gupa.nextgenshare.com",
            "affiliation": "N",
            "endpointDescription": "Direct Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Direct Edge",
            "address_1": "500 Medical Center Blvd",
            "address_2": "Suite 220",
            "city": "Lawrenceville",
            "state": "GA",
            "country_code": "US",
            "postal_code": "30046",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Stephanie Danielle Allen-Perry, LCSW
• David Allen
• Kaleah Prentice Allen
• Neshunta Vannell Allen, LPN
• Quanisha Allen
• Shelby Elizabeth Allen, CCC-SLP
• Brandi Allgood, RN
• Alliance Health Care Inc
• Alliance Home Care Servies LLC
• Allied Ankle & Foot Care Centers PC

• Urology Physician in Lawrenceville, GA
• Providers in Lawrenceville, GA by specialty
• Urology Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.