Individual provider Active NPI

Peter Wrobel, M.D

  • Family Medicine Physician
  • Waycross, GA
National Provider Identifier
1396761987
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
040285 Issued in GA
Practice address
1718 Reynolds Street
Waycross, GA 31501-4574
Phone
(912) 283-1359
Fax
(912) 283-1362
NPI assigned
Jul 15, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 040285 GA Primary

Addresses

Primary practice location

1718 Reynolds Street
Waycross, GA 31501-4574

Mailing address

1718 Reynolds Street
Waycross, GA 31501-4574
Phone (912) 283-1359

Other practice location 1

1710 Reynolds Street
Waycross, GA 31501-3150
Phone (912) 283-1359

Other practice location 2

1720 Reynolds Street
Waycross, GA 31501-3150
Phone (912) 283-1359

Other practice location 3

632 Ferncrest Dr
Sandersville, GA 31082-1863
Phone (912) 283-1359

Other practice location 4

1230 Bald Ridge Marina Rd Ste 500
Cumming, GA 30041-7536
Phone (678) 513-1600

Other practice location 5

1230 Bald Ridge Marina Rd Ste 550
Cumming, GA 30041-7536
Phone (470) 695-7264

Other identifiers 2

IdentifierTypeStateIssuer
000672339FMedicaidGA
000672339EMedicaidGA

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
I20080514000336 GA Practitioner - Family Practice 0042389256 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Peter Wrobel MD PCGroup PAC ID 0345390795, 3 clinicians

Practice addresses (Care Compare)

1720 Old Reynolds St
Waycross, GA 31501-1036
Phone 9122831359185

Hospital & facility affiliations

  • Amedisys Home Health Home health agency, Waycross, GA, CCN 117076
  • Memorial Satilla Health Hospital, Waycross, GA, CCN 110003

Merit-based Incentive Payment System (MIPS)

Final score
99.41 of 100Reported as individual
Quality
99.47
Promoting interoperability
99
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Varicose vein removal427
Melanoma (skin cancer) excision1-10
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
040285GAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Peter Wrobel MD PC Family Medicine CurrentSince Mar 25, 2009 Accepting new patients
Southeast Georgia Primary Care Family Medicine Current Accepting new patients

Locations

100 Liberty Blvd
Ste 110
Canton, GA 30114
Phone (678) 513-1600

636 E Main St
Cartersville, GA 30121
Phone (678) 568-7858

1230 Bald Ridge Marina Rd
Ste 500
Cumming, GA 30041
Phone (678) 513-1600

632 Ferncrest Dr
Sandersville, GA 31082
Phone (478) 552-0966

1718 Old Reynolds St
Waycross, GA 31501
Phone 9122831359200

409 Uvalda St
Waycross, GA 31501
Phone (229) 391-3500

1720 Old Reynolds St
Waycross, GA 31501
Phone (912) 809-6401

1507 Alice St
Waycross, GA 31501
Phone (912) 283-7220

Interoperability endpoints

  • Direct secure messaging: peter.wrobel.1@27501.direct.athenahealth.com

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.

Hospital & facility affiliations 2

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": "1152921600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1396761987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1718 REYNOLDS STREET",
            "city": "WAYCROSS",
            "state": "GA",
            "postal_code": "315014574",
            "telephone_number": "912-283-1359",
            "fax_number": "912-283-1362"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1718 REYNOLDS STREET",
            "city": "WAYCROSS",
            "state": "GA",
            "postal_code": "315014574",
            "telephone_number": "912-283-1359",
            "fax_number": "912-283-1362"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1710 Reynolds Street",
            "address_purpose": "LOCATION",
            "city": "Waycross",
            "state": "GA",
            "postal_code": "315013150",
            "country_code": "US",
            "telephone_number": "912-283-1359",
            "fax_number": "912-283-1359",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1720 Reynolds Street",
            "address_purpose": "LOCATION",
            "city": "Waycross",
            "state": "GA",
            "postal_code": "315013150",
            "country_code": "US",
            "telephone_number": "912-283-1359",
            "fax_number": "912-283-1359",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "632 Ferncrest Dr",
            "address_purpose": "LOCATION",
            "city": "Sandersville",
            "state": "GA",
            "postal_code": "310821863",
            "country_code": "US",
            "telephone_number": "912-283-1359",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1230 Bald Ridge Marina Rd Ste 500",
            "address_purpose": "LOCATION",
            "city": "Cumming",
            "state": "GA",
            "postal_code": "300417536",
            "country_code": "US",
            "telephone_number": "678-513-1600",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1230 Bald Ridge Marina Rd Ste 550",
            "address_purpose": "LOCATION",
            "city": "Cumming",
            "state": "GA",
            "postal_code": "300417536",
            "country_code": "US",
            "telephone_number": "470-695-7264",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WROBEL",
        "first_name": "PETER",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-15",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "040285",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000672339F",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000672339E",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Waycross, GA

Sources for this page

Verify at the official NPI Registry.