Vijay K. Mahathre, M.D.
Individual provider Active NPI Family Medicine Physician · Hazlehurst, GA
NPI 1528047016 · NPPES record last updated Dec 11, 2019
Key facts
- NPI
- 1528047016
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 41612 (GA)
- Practice address
- 163 S Tallahassee St
Hazlehurst, GA 31539-6465 - Phone
- (912) 375-7781
- Fax
- (912) 375-4055
- NPI assigned
- Jan 12, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 15
Hospital & facility affiliations 3
Medicare Care Compare profile
- Specialty
- Emergency Medicine
- Education
- Other, 1981
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Southland Emergency Medical Services Consolidated, LLC
Southland Cochran Emergency Medical Services LLC
Baldwin Emergency Group, LLC
Practice addresses (Care Compare)
145 E Peacock St
Cochran, GA 31014-7846
Phone (229) 200-4950
821 N Cobb St
Milledgeville, GA 31061-2343
Phone (478) 454-3500
Hospital & facility affiliations
- Navicent Health Baldwin
- Bleckley Memorial Hospital
- Bleckley Memorial Hospital
Merit-based Incentive Payment System (MIPS)
- Final score
- 86.46 of 100
- Quality
- 71.9
- Improvement activities
- 40
- Cost
- 87.09
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in GA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20040522000167 | GA | Practitioner - Emergency Medicine | 8527059005 | Reassigns benefits to 10 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 041612 | GA | MD | Emergency Medicine Physician |
| 41612 | GA | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| United Emergency Services, Inc. | Emergency Medicine | Current |
Accepting new patients |
| Acs Primary Care Physicians - Southeast PC | Emergency Medicine | Current |
Accepting new patients |
| Southland Dodge Emergency Medical Services, LLC | Emergency Medicine | Current |
Accepting new patients |
| Georgia Emergency Group, LLC | Emergency Medicine | Current |
Accepting new patients |
| Southland Consolidated Emergency Services, LLC | Emergency Medicine | Current |
Accepting new patients |
| Ben Hill Emergency Group LLC | Emergency Medicine | Current |
Accepting new patients |
| Southland Emergency Medical Services Consolidated, LLC | Family Medicine | Current |
Accepting new patients |
| Southland Cochran Emergency Medical Services, LLC | Emergency Medicine | Current |
Accepting new patients |
| Southland Optim Screven Emergency Medical Services LLC | Emergency Medicine | Current |
Accepting new patients |
| Baldwin Emergency Group, LLC | Emergency Medicine | Current |
Accepting new patients |
| Dodge Emergency Group LLC | Emergency Medicine | Past | Accepting new patients |
| Sterling Emergency Services of the Southeast Inc | Emergency Medicine | Past | Accepting new patients |
| Nes Georgia, Inc. | Emergency Medicine | Past | Accepting new patients |
| Nes Georgia, Inc. | Emergency Medicine | Past | Accepting new patients |
| Morningside Emergency Physicians LLC | Emergency Medicine | Past | Accepting new patients |
Locations
145 E Peacock St
Cochran, GA 31014
Phone (229) 200-4950
200 Industrial Blvd
Dublin, GA 31021
Phone (478) 274-3865
901 Griffin Ave
Eastman, GA 31023
Phone (478) 374-4000
101 Lake Oconee Pkwy
Eatonton, GA 31024
Phone (706) 485-0907
4 Medical Dr
Elberton, GA 30635
Phone (706) 213-2527
200 Perry House Rd
Fitzgerald, GA 31750
Phone (229) 424-1461
88 Martin Luther King Jr Dr
Forsyth, GA 31029
Phone (419) 994-2521
88 Martin Luther King Jr Dr
#D
Forsyth, GA 31029
Phone (419) 994-2521
601 S 8th St
Griffin, GA 30224
Phone (770) 228-2721
163 S Tallahassee St
Hazlehurst, GA 31539
Phone (912) 375-7781
1050 McDonough Rd
Jackson, GA 30233
Phone (770) 775-7861
350 Hospital Dr
Macon, GA 31217
Phone (478) 751-0367
400 Charter Blvd
Macon, GA 31210
Phone (478) 757-6000
821 N Cobb St
Milledgeville, GA 31061
Phone (478) 454-3500
2151 W Spring St
Monroe, GA 30655
Phone (770) 267-1792
898 College St
Monticello, GA 31064
Phone (706) 468-0988
215 Mims Rd
Sylvania, GA 30467
Phone (912) 557-1207
5995 Spring St
Warm Springs, GA 31830
Phone (706) 632-4374
Interoperability endpoints
- https://api.platform.athenahealth.com/14272/brand/70/csg/1/fhir/r4
- vjay.maharhre@oconeeregional.gadirect.net
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | 041612 | GA | |
| Family Medicine Physician | 207Q00000X | 41612 | GA | Yes |
Addresses
Primary practice location
163 S Tallahassee St
Hazlehurst, GA 31539-6465
Mailing address
PO Box 277329
Atlanta, GA 30384-7329
Phone (800) 377-8721
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 52581283022 | Other | GA | BLUECROSS BLUESHIELD |
| 000721201S | Medicaid | GA |
Other providers in Hazlehurst, GA
- Alexis Leggett
- Kaylynn Leggett
- Jade Denice Lott
- Virginia Barnwell Lott
- Wynne Kendra Lott
- Candace Lynn Martinez
- Michael Lloyd Mason
- Johanna McDowell
- Landyn Miller
- Mitch'S Pharmacy, LLC
All providers in Hazlehurst, GA · Family Medicine Physician in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 11, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.