NPIMap

Individual provider Active NPI

Charles Adam Decook, MD

  • Orthopaedic Surgery Physician
  • Cumming, GA
National Provider Identifier
1386794113
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
63576 Issued in GA
Practice address
2000 Howard Farm Dr Ste 200
Cumming, GA 30041-6081
Phone
(770) 292-6500
Fax
(770) 292-6535
NPI assigned
Jan 12, 2007
Last updated
Mar 7, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 200301449 NC
Orthopaedic Surgery Physician 207X00000X 0101245422 VA
Orthopaedic Surgery Physician 207X00000X 63576 GA Primary

Addresses

Primary practice location

2000 Howard Farm Dr Ste 200
Cumming, GA 30041-6081

Mailing address

2000 Howard Farm Dr Ste 200
Cumming, GA 30041-6081
Phone (770) 292-6500

Other identifiers 16

IdentifierTypeStateIssuer
509140519CMedicaidGA
557507OtherGAWELLCARE
89136RRMedicaidNC
9485152OtherGAAETNA
0101245422OtherVALICENSE
509140519AMedicaidGA
P01659745OtherGARR MEDICARE
509140519OMedicaidGA
52241691OtherGABCBS
7493615OtherGACIGNA
P00903599OtherGAMEDICARE RAILROAD
01353242OtherGAAMERIGROUP
509140519QMedicaidGA
509140519BMedicaidGA
509140519PMedicaidGA
P01726634OtherGARR MEDICARE

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address charles.decook@northsidehospital.cernerdirect.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100921000349 GA Practitioner - Orthopedic Surgery 3779562244 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Rush Medical College of Rush University, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Physiotherapy Associates IncGroup PAC ID 3577470442, shared by 50 NPIs, 1,432 clinicians
Advanced Joint Surgery Specialists, LLCGroup PAC ID 2961795190, 46 clinicians
Esop Rehabilitation LLCGroup PAC ID 9739305749, shared by 9 NPIs, 224 clinicians

Practice addresses (Care Compare)

100 Mountain View Dr
Cumming, GA 30040-2434
Phone (770) 889-2163

1200 Northside Forsyth Dr
Cumming, GA 30041-7659
Phone (770) 844-3200

3400 A Old Milton Pkwy
Alpharetta, GA 30005-4438
Phone (770) 667-4343

875 Flat Shoals Rd SE
Conyers, GA 30094-6640
Phone (770) 785-7669

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
79.29 of 100Reported as group
Quality
67.84
Promoting interoperability
73
Improvement activities
40
Cost
85.62

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hip replacement300
Knee replacement386

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
200301449NCMDFamily Medicine Physician
63576GAMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Northside Surgical Professional Services LLC CurrentSince Nov 1, 2015 Accepting new patients
Advanced Joint Surgery Specialists, LLC Orthopaedic Surgery CurrentSince Aug 1, 2016 Accepting new patients
Davie Medical Center Past Accepting new patients

Locations

3400 Old Milton Pkwy
Ste 290
Alpharetta, GA 30005
Phone (770) 667-4343

3400 Old Milton Pkwy
Ste C290
Alpharetta, GA 30005
Phone (770) 667-4337

1505 Northside Blvd
Ste 3500
Cumming, GA 30041
Phone (770) 292-3120

2000 Howard Farm Dr
Ste 200
Cumming, GA 30041
Phone (770) 667-4337

2000 Howard Farm Dr
Ste T100
Cumming, GA 30041
Phone (470) 839-9200

1000 Johnson Fy Rd NE
Sandy Springs, GA 30342
Phone (404) 851-1000

Interoperability endpoints

  • Direct secure messaging: charles.decook@northsidehospital.cernerdirect.com

Organizations & group practices 3

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.

Hospital & facility affiliations 6

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": "1168560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1386794113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 HOWARD FARM DR STE 200",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "300416081",
            "telephone_number": "770-292-6500",
            "fax_number": "770-292-6535"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 HOWARD FARM DR STE 200",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "300416081",
            "telephone_number": "770-292-6500",
            "fax_number": "770-292-6535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DECOOK",
        "first_name": "CHARLES",
        "middle_name": "ADAM",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-12",
        "last_updated": "2023-03-07",
        "certification_date": "2020-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "200301449",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "VA",
            "license": "0101245422",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "GA",
            "license": "63576",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "509140519C",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLCARE",
            "identifier": "557507",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89136RR",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "9485152",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "0101245422",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "509140519A",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P01659745",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "509140519O",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "52241691",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "7493615",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "P00903599",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIGROUP",
            "identifier": "01353242",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "509140519Q",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "509140519B",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "509140519P",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P01726634",
            "state": "GA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "charles.decook@northsidehospital.cernerdirect.com",
            "affiliation": "N",
            "endpointDescription": "Direct Messaging",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Direct Message",
            "address_1": "1505 Northside Forsyth Blvd",
            "address_2": "Ste 3500",
            "city": "Cumming",
            "state": "GA",
            "country_code": "US",
            "postal_code": "30041",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Cumming, GA

Sources for this page

Verify at the official NPI Registry.