Kevin Conrad Pelletier, M.D.

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

A148657 Issued in CA

Practice address

5555 Peachtree Dunwoody Rd Ste G65
Atlanta, GA 30342-1710

Phone

(404) 843-3323

Fax

(404) 574-5944

NPI assigned

Apr 16, 2015

Last updated

Oct 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 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective May 15, 2024 through May 15, 2028

Merit-based Incentive Payment System (MIPS)

Final score

72.17 of 100Reported as group

Quality

61.75

Promoting interoperability

99

Improvement activities

40

Cost

46.31

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Peachtree Spine & Pain Physicians, Inc

  dba Peachtree Spine Physicians, Inc

  • Pain Medicine (Physical Medicine & Rehabilitation) Physician
  • Hapeville, GA
  • NPI 1336458355
  NPD (past)
• April Lopez Chiropractic. a Professional Corporation

  dba Stadium Chiropractic

  • Rehabilitation Chiropractor
  • Orange, CA
  • NPI 1255452835
  NPD (past)

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

{
    "created_epoch": "1429142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666224000000",
    "number": "1518354554",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3010 BEARD RD",
            "city": "NAPA",
            "state": "CA",
            "postal_code": "945583442",
            "telephone_number": "707-255-8825",
            "fax_number": "707-255-9325"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5555 PEACHTREE DUNWOODY RD STE G65",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303421710",
            "telephone_number": "404-843-3323",
            "fax_number": "404-574-5944"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PELLETIER",
        "first_name": "KEVIN",
        "middle_name": "CONRAD",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-04-16",
        "last_updated": "2022-10-20",
        "certification_date": "2022-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "CA",
            "license": "A148657",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ornella Gabriella Pelissero
• Allan E Peljovich, M.D.
• Lauren Jane Pelkey, DO
• Andrea Pelle, MD
• Lillian Pellegrino, LPC
• Mary Pelling
• Richard Antonio Pellizzari II, MD
• Dawn Pelow
• Arie E Pelta, M.D.
• Bernadette A Peltier, MD

• Physical Medicine & Rehabilitation Physician in Atlanta, GA
• Providers in Atlanta, GA by specialty
• Physical Medicine & Rehabilitation Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 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; Opt Out Affidavits.
• 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.