Individual provider Active NPI

Michael Henry Genz, MD

  • Surgery Physician
  • Atlanta, GA
National Provider Identifier
1457715609
Registry record updated Aug 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
92141 Issued in GA
Practice address
1100 Johnson Ferry Rd Ste 410
Atlanta, GA 30342-1709
Phone
(404) 847-0664
Fax
(404) 250-1694
NPI assigned
Apr 13, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X A172108 CA
Student in an Organized Health Care Education/Training Program 390200000X
Surgery Physician 208600000X 92141 GA Primary

Addresses

Primary practice location

1100 Johnson Ferry Rd Ste 410
Atlanta, GA 30342-1709

Mailing address

1100 Johnson Ferry Rd Ste 410
Atlanta, GA 30342-1709
Phone (404) 847-0664

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
I20220913004018 GA Practitioner - General Surgery 3072901719 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Mercer University School of Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northside Surgical Professional Services LLCGroup PAC ID 8628253424, 367 clinicians

Practice addresses (Care Compare)

1000 Johnson Ferry NE
Atlanta, GA 30342-1606

1000 Johnson Ferry Rd NE
Atlanta, GA 30342-1606
Phone (404) 851-8000

1100 Johnson Ferry Rd
Suite 410
Atlanta, GA 30342-1709
Phone (404) 847-0664

1110 W Peachtree St NW
Atlanta, GA 30309-3609

Hospital & facility affiliations

  • Northside Hospital Hospital, Atlanta, GA, CCN 110161
  • Northside Hospital Forsyth Hospital, Cumming, GA, CCN 110005

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hernia repair - groin (open)1-10
Hernia repair (minimally invasive)24
Melanoma (skin cancer) excision1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A172108CAMDSurgery Physician
92141GAMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Northside Surgical Professional Services LLC Surgery CurrentSince Sep 1, 2022 Accepting new patients

Locations

3400 Old Milton Pkwy
Ste A415
Alpharetta, GA 30005
Phone (678) 352-0254

4800 Olde Towne Pkwy
Ste 110
Marietta, GA 30068
Phone (678) 297-9707

1000 Johnson Ferry Rd
Sandy Springs, GA 30342
Phone (404) 851-8737

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

1100 Johnson Ferry Rd
Ste 410
Sandy Springs, GA 30342
Phone (404) 847-0664

4298 W Atlanta Rd SE
Ste 320
Smyrna, GA 30080

1462 Montreal Rd
Ste 303
Tucker, GA 30084
Phone (404) 508-4320

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.

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": "1460505600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660608000000",
    "number": "1457715609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 JOHNSON FERRY RD STE 410",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303421709",
            "telephone_number": "404-847-0664",
            "fax_number": "404-250-1694"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 JOHNSON FERRY RD STE 410",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303421709",
            "telephone_number": "404-847-0664",
            "fax_number": "404-250-1694"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GENZ",
        "first_name": "MICHAEL",
        "middle_name": "HENRY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-04-13",
        "last_updated": "2022-08-16",
        "certification_date": "2022-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "CA",
            "license": "A172108",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "GA",
            "license": "92141",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.