Samuel Joseph Dolezal, MD, PHD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

65020 Issued in MN

Practice address

3320 Old Jefferson Rd Ste 600
Athens, GA 30607-1463

Phone

(706) 353-2990

Fax

(706) 353-2992

NPI assigned

Jun 23, 2016

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in IN

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

Internal Medicine

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Baptist Health Medical Group IncGroup PAC ID 5597867184, 2,431 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Caretenders Home health agency, New Albany, IN, CCN 157571
• Baptist Home Health Care of Indiana Home health agency, New Albany, IN, CCN 157152
• Carefirst Rehab LLC Home health agency, Sellersburg, IN, CCN 157657
• Baptist Health Floyd Hospital, New Albany, IN, CCN 150044
• Baptist Health Louisville Hospital, Louisville, KY, CCN 180130

Merit-based Incentive Payment System (MIPS)

Final score

94.29 of 100Reported as apm

Quality

87.32

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine, Doctor of Philosophy

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: sdolezal324441@excellian.direct.allina.com

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.

• Baptist Health Medical Group Inc

  • Urgent Care Clinic/Center
  • Louisville, KY
  • NPI 1508269200

  IN, Single Specialty

  Medicare reassignment Care Compare group NPD
• Baptist Health Medical Group Inc

  • Internal Medicine Physician
  • Louisville, KY
  • NPI 1780961300
  NPD
• Baptist Health Medical Group Inc

  • Rural Health Clinic/Center
  • Dawson Springs, KY
  • NPI 1982178216

  Single Specialty

  NPD

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

• Baptist Healthcare System Inc.

  • General Acute Care Hospital
  • Louisville, KY
  • NPI 1265539498
  Care Compare affiliation
• Baptist Healthcare System, Inc.

  • General Acute Care Hospital
  • New Albany, IN
  • NPI 1497798847
  Care Compare affiliation
• Baptist Healthcare System, Inc.

  • Home Health Agency
  • New Albany, IN
  • NPI 1972544955
  Care Compare affiliation
• Carefirst Rehab LLC

  • Home Health Agency
  • Sellersburg, IN
  • NPI 1194011056
  Care Compare affiliation
• Caretenders Visiting Services of Kentuckiana, LLC

  • Home Health Agency
  • New Albany, IN
  • NPI 1366549560
  Care Compare affiliation

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

{
    "created_epoch": "1466640000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669075200000",
    "number": "1326499187",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3320 OLD JEFFERSON RD BLDG 700",
            "city": "ATHENS",
            "state": "GA",
            "postal_code": "306071465",
            "telephone_number": "706-353-2990",
            "fax_number": "706-353-2992"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3320 OLD JEFFERSON RD STE 600",
            "city": "ATHENS",
            "state": "GA",
            "postal_code": "306071463",
            "telephone_number": "706-353-2990",
            "fax_number": "706-353-2992"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOLEZAL",
        "first_name": "SAMUEL",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "MD, PHD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-06-23",
        "last_updated": "2022-11-22",
        "certification_date": "2022-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "MN",
            "license": "65020",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stephanie Kamila Doblack-Mellum, BS
• Doc Todd Love
• Michael D Dock, MHC
• Karen E Dodson, NP
• Christopher E Doerr, D.O.
• Donaldson Assoc
• Dorran Donaldson, LPC
• Kereisha N Donegal, MD
• Jing Dong, MD PHD
• Michelle Scott Doolittle, FNP-C

• Internal Medicine Physician in Athens, GA
• Providers in Athens, GA by specialty
• Internal Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2022; 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.