Andrew Paul Barak, DO

Primary specialty

Otolaryngology PhysicianTaxonomy code 207Y00000X

License

67354 Issued in GA

Practice address

6130 Prestley Mill Rd Ste C
Douglasville, GA 30134-2288

Phone

(678) 838-3903

Fax

(678) 838-7454

NPI assigned

May 3, 2006

Last updated

Apr 20, 2022By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

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

Specialty

Otolaryngology

Education

At Still University of Health Sciences, College of Osteo Med, Kirksville, 1978

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Northside Surgical Professional Services LLCGroup PAC ID 8628253424, 367 clinicians

Ear, Nose and Throat Plastic Surgery CenterGroup PAC ID 2961497318, 4 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Wellstar Cobb Medical Center Hospital, Austell, GA, CCN 110143
• Wellstar Douglas Medical Center Hospital, Douglasville, GA, CCN 110184

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

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.

• Ear, Nose & Throat Plastic Surgery Center

  • Otolaryngology/Facial Plastic Surgery Physician
  • Douglasville, GA
  • NPI 1821163577
  Medicare reassignment Care Compare group NPD
• Northside Surgical Professional Services LLC

  • Surgery Physician
  • Atlanta, GA
  • NPI 1356630990
  Medicare reassignment Care Compare group NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Cobb Hospital, Inc

  dba Wellstar Cobb Hospital

  • General Acute Care Hospital
  • Austell, GA
  • NPI 1467420448
  Care Compare affiliation
• Douglas Hospital, Inc.

  dba Wellstar Douglas Hospital

  • General Acute Care Hospital
  • Douglasville, GA
  • NPI 1649247974
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1146614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650412800000",
    "number": "1508824152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2323 E PARIS AVE SE",
            "address_2": "STE 102",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495462414",
            "telephone_number": "616-285-3733",
            "fax_number": "616-285-5960"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6130 PRESTLEY MILL RD STE C",
            "city": "DOUGLASVILLE",
            "state": "GA",
            "postal_code": "301342288",
            "telephone_number": "678-838-3903",
            "fax_number": "678-838-7454"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARAK",
        "first_name": "ANDREW",
        "middle_name": "PAUL",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-03",
        "last_updated": "2022-04-20",
        "certification_date": "2022-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "MI",
            "license": "AB007458",
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "GA",
            "license": "67354",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michele Balthrope, LCSW
• Quiera Banks, PHD
• Shahagony Banks, CIT
• Stephanie Banks, RBT
• Bhumika Banugaria
• Keturah Barnard
• Ivorine Barnes, MS RD
• Walida S Barr, LPN
• Patricia Annette Barrett, FNP-BC
• Natasha Barrow

• Otolaryngology Physician in Douglasville, GA
• Providers in Douglasville, GA by specialty
• Otolaryngology Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2022; 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.

Verify at the official NPI Registry.