Individual provider Active NPI

Mathew M. John, D.P.M

  • Foot & Ankle Surgery Podiatrist
  • Marietta, GA
National Provider Identifier
1497740229
Registry record updated Apr 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
000926 Issued in GA
Practice address
2790 Sandy Plains Rd
Suite 300
Marietta, GA 30066-4378
Phone
(770) 977-3668
Fax
(770) 578-0033
NPI assigned
Sep 19, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 19, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X 000926 GA Primary

Addresses

Primary practice location

2790 Sandy Plains Rd
Suite 300
Marietta, GA 30066-4378

Mailing address

2790 Sandy Plains Rd
Suite 300
Marietta, GA 30066-4378
Phone (770) 977-3668

Other identifiers 1

IdentifierTypeStateIssuer
288814528AMedicaidGA

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060331000263 GA Practitioner - Podiatry 9537177639 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
William M. Scholl College of Podiatric Medicine, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2790 Sandy Plains Rd
Suite 300
Marietta, GA 30066-4378
Phone 7709773668106

Hospital & facility affiliations

  • Wellstar Windy Hill Hospital Long-term care hospital, Marietta, GA, CCN 112007

Merit-based Incentive Payment System (MIPS)

Final score
7.5 of 100Reported as individual
Quality
15
Improvement activities
0

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue21
Removal of skin lesions98
Removal of nail tissue211
Removal or shaving of skin growth50
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
000926GAMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Ankle and Foot Centers Inc Foot & Ankle Surgery CurrentSince Aug 20, 2001 Accepting new patients

Locations

2790 Sandy Plains Rd
Ste 300
Marietta, GA 30066
Phone (770) 977-3668

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 1

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": "1127088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713484800000",
    "number": "1497740229",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2790 SANDY PLAINS RD",
            "address_2": "SUITE 300",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300664378",
            "telephone_number": "770-977-3668",
            "fax_number": "770-578-0033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2790 SANDY PLAINS RD",
            "address_2": "SUITE 300",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300664378",
            "telephone_number": "770-977-3668",
            "fax_number": "770-578-0033"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHN",
        "first_name": "MATHEW",
        "middle_name": "M.",
        "name_prefix": "Dr.",
        "credential": "D.P.M",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-19",
        "last_updated": "2024-04-19",
        "certification_date": "2024-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "GA",
            "license": "000926",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "288814528A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Marietta, GA

Sources for this page

Verify at the official NPI Registry.