Individual provider Active NPI

Doreen Luis, MD

  • Emergency Medicine Physician
  • Augusta, GA
National Provider Identifier
1518070010
Registry record updated Dec 19, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
37601 Issued in GA
Practice address
1350 Walton Way
Augusta, GA 30901-2612
Phone
(706) 722-9011
NPI assigned
Aug 17, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 19, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 37601 GA Primary

Addresses

Primary practice location

1350 Walton Way
Augusta, GA 30901-2612

Mailing address

PO Box 532780
Atlanta, GA 30353-2780
Phone (800) 639-0579

Other identifiers 1

IdentifierTypeStateIssuer
000579785HMedicaidGA

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
I20040713000337 GA Practitioner - Emergency Medicine 4880672195 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
95.67 of 100Reported as group
Improvement activities
40
Cost
79.56

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
37601GAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Acs Primary Care Physicians - Southeast PC Emergency Medicine CurrentSince Apr 1, 2022 Accepting new patients
Peach State Emergency Physicians LLC Emergency Medicine CurrentSince May 17, 2024 Accepting new patients
Sterling Emergency Services of the Southeast Inc Emergency Medicine Past Accepting new patients
Inphynet Primary Care Physicians Southeast PC Emergency Medicine Past Accepting new patients

Locations

2260 Wrightsboro Rd
Augusta, GA 30904
Phone (706) 481-7000

1350 Walton Way
Augusta, GA 30901
Phone (706) 722-9011

200 Industrial Blvd
Dublin, GA 31021
Phone (478) 274-3865

2151 W Spring St
Monroe, GA 30655
Phone (770) 267-1792

2460 Washington Rd
Thomson, GA 30824
Phone (706) 595-1411

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1155772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1198022400000",
    "number": "1518070010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 532780",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303532780",
            "telephone_number": "800-639-0579"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1350 WALTON WAY",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309012612",
            "telephone_number": "706-722-9011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUIS",
        "first_name": "DOREEN",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-17",
        "last_updated": "2007-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "GA",
            "license": "37601",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000579785H",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Augusta, GA

Sources for this page

Verify at the official NPI Registry.