Active NPI
Stephen G Preas, M.D.
- Psychiatry Physician
- Loganville, GA
National Provider Identifier
1417115452
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 019752
- Practice address
- 2430 Tucker Dr
BLDG a
Loganville, GA 30052-4390 - Phone
- (770) 554-8812
- Fax
- (770) 554-9810
- NPI assigned
- May 27, 2008
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 019752 | GA | Primary |
Addresses
Primary practice location
2430 Tucker Dr
BLDG a
Loganville, GA 30052-4390
Mailing address
2430 Tucker Dr
BLDG a
Loganville, GA 30052-4390
Phone (770) 554-8812
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
Care Compare profile
Medicare Care CompareMerit-based Incentive Payment System (MIPS)
- Final score
- 49.38 of 100
- Quality
- 4.35
- Promoting interoperability
- 0
- Improvement activities
- 40
- Cost
- 76.92
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 019752 | GA | MD | Psychiatry Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Promedica, Inc. | Past | Accepting new patients |
Organizations & group practices 1
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.
-
dba Promedica Psychiatry Group
- Mental Health Counselor
- Loganville, GA
- NPI 1922036508
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1211846400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1319068800000",
"number": "1417115452",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2430 TUCKER DR",
"address_2": "BLDG A",
"city": "LOGANVILLE",
"state": "GA",
"postal_code": "300524390",
"telephone_number": "770-554-8812",
"fax_number": "770-554-9810"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2430 TUCKER DR",
"address_2": "BLDG A",
"city": "LOGANVILLE",
"state": "GA",
"postal_code": "300524390",
"telephone_number": "770-554-8812",
"fax_number": "770-554-9810"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PREAS",
"first_name": "STEPHEN",
"middle_name": "G",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-05-27",
"last_updated": "2011-10-20",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "GA",
"license": "019752",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Loganville, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2011; 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.