Individual provider Active NPI

Michael Nordsiek, DO

  • Urology Physician
  • Johns Creek, GA
National Provider Identifier
1376982124
Registry record updated Apr 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
82881 Issued in GA
Practice address
10730 Medlock Bridge Rd Ste 700
Johns Creek, GA 30097-2637
Phone
(470) 579-5600
NPI assigned
Jun 14, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X 2017-02525 NC
Urology Physician 208800000X 82881 GA Primary

Addresses

Primary practice location

10730 Medlock Bridge Rd Ste 700
Johns Creek, GA 30097-2637

Mailing address

1551 Janmar Rd
Snellville, GA 30078-5606
Phone (678) 344-8900

Other practice location 1

501 Crownpointe Way
Lawrenceville, GA 30046-7702
Phone (678) 344-8900

Other practice location 2

3075 Ronald Reagan Blvd Ste 501
Cumming, GA 30041-6052
Phone (678) 344-8900

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
I20190727000399 GA Practitioner - Urology 8527315365 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
Philadelphia College of Osteopathic Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Advanced Urology of Ga-East, PCGroup PAC ID 1658725668, 17 clinicians

Practice addresses (Care Compare)

1561 Janmar Rd
Snellville, GA 30078-5639
Phone (678) 344-8900

Hospital & facility affiliations

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

Merit-based Incentive Payment System (MIPS)

Final score
83.66 of 100Reported as group
Quality
69.85
Promoting interoperability
100
Improvement activities
40
Cost
75.7

Procedures performed for Medicare patients

ProcedureNumber of procedures
Prostate resection1-10
Removal of skin lesions1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Urology of Ga-East, PC Urology CurrentSince Sep 1, 2023 Accepting new patients
Advanced Urology Institute of Georgia Urology CurrentSince May 13, 2019 Accepting new patients
Advanced Urology Institute of Georgia Urology Current Accepting new patients
Advanced Urology Institute of Georgia, PC Urology CurrentSince May 13, 2019 Accepting new patients

Locations

2695 Old Winder Hwy
Ste 150
Braselton, GA 30517
Phone (678) 400-0654

2205 Riverstone Blvd
Ste 101
Canton, GA 30114
Phone (770) 590-1078

1366 Wellbrook Cir NE
#B
Conyers, GA 30012
Phone (770) 922-9622

3075 Ronald Reagan Blvd
#501
Cumming, GA 30041
Phone (678) 736-6000

2713 Charles Hardy Pkwy
Ste 122
Dallas, GA 30157
Phone (770) 505-3162

2711 Irvin Way
Ste 102
Decatur, GA 30030

10730 Medlock Bridge Rd
Ste 110
Johns Creek, GA 30097
Phone (860) 886-1956

10730 Medlock Bridge Rd
Ste 120
Johns Creek, GA 30097

501 Crownpointe Way
Lawrenceville, GA 30046
Phone (404) 341-6583

1371 Church Street Ext NE
#200
Marietta, GA 30060
Phone (678) 481-0579

1371 Church Street Ext NE
#100
Marietta, GA 30060

11660 Alpharetta Hwy
Ste 700
Roswell, GA 30076
Phone (678) 839-9973

11660 Alpharetta Hwy
Ste 720
Roswell, GA 30076
Phone 6783448900156

1450 S Johnson Ferry Rd
Sandy Springs, GA 30319
Phone (404) 800-4280

1450 S Johnson Ferry Rd
Ste 100
Sandy Springs, GA 30319
Phone 6783448900156

1800 Tree Ln
Ste 280
Snellville, GA 30078
Phone (404) 919-4876

1561 Janmar Rd
Snellville, GA 30078
Phone 6783448900102

1551 Janmar Rd
Snellville, GA 30078

1557 Janmar Rd
Snellville, GA 30078
Phone (404) 348-4421

Organizations & group practices 4

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 4

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": "1371168000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714435200000",
    "number": "1376982124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1551 JANMAR RD",
            "city": "SNELLVILLE",
            "state": "GA",
            "postal_code": "300785606",
            "telephone_number": "678-344-8900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10730 MEDLOCK BRIDGE RD STE 700",
            "city": "JOHNS CREEK",
            "state": "GA",
            "postal_code": "300972637",
            "telephone_number": "470-579-5600"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "501 Crownpointe Way",
            "address_purpose": "LOCATION",
            "city": "Lawrenceville",
            "state": "GA",
            "postal_code": "300467702",
            "country_code": "US",
            "telephone_number": "678-344-8900",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3075 Ronald Reagan Blvd Ste 501",
            "address_purpose": "LOCATION",
            "city": "Cumming",
            "state": "GA",
            "postal_code": "300416052",
            "country_code": "US",
            "telephone_number": "678-344-8900",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NORDSIEK",
        "first_name": "MICHAEL",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-06-14",
        "last_updated": "2024-04-30",
        "certification_date": "2024-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "NC",
            "license": "2017-02525",
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "GA",
            "license": "82881",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Johns Creek, GA

Sources for this page

Verify at the official NPI Registry.