Individual provider Active NPI

Michael Thomas Bianco, D.O.

  • Internal Medicine Physician
  • Alpharetta, GA
National Provider Identifier
1538390158
Registry record updated May 12, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
67533 Issued in GA
Practice address
12315 Crabapple Rd
Suite 108
Alpharetta, GA 30004-6329
Phone
(678) 254-2333
Fax
(678) 254-2332
NPI assigned
Jul 30, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 12, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 25MB09009700 NJ
Internal Medicine Physician 207R00000X 67533 GA Primary

Addresses

Primary practice location

12315 Crabapple Rd
Suite 108
Alpharetta, GA 30004-6329

Mailing address

12315 Crabapple Rd
Suite 108
Alpharetta, GA 30004-6329
Phone (678) 254-2333

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
I20120904000753 GA Practitioner - Internal Medicine 8426205097 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
67533GAMDInternal Medicine Physician
25MB09009700NJMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cogent Healthcare of Georgia PC Internal Medicine CurrentSince Apr 30, 2017 Accepting new patients

Locations

1170 Cleveland Ave
East Point, GA 30344
Phone (404) 305-3500

367 Clear Creek Pkwy
Lavonia, GA 30553
Phone (706) 356-7800

11 Upper Riverdale Rd SW
Riverdale, GA 30274
Phone (770) 897-7277

Interoperability endpoints

  • Direct secure messaging: michael.bianco@1434047938564.direct.elationemr.com

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Golden Rule Hospice, LLCAlpharetta, GA, CCN 111776 Hospice Contracted Managing Employee Nov 11, 2022

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

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.

NPI Registry JSON

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

{
    "created_epoch": "1248912000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1399852800000",
    "number": "1538390158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12315 CRABAPPLE RD",
            "address_2": "SUITE 108",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "300046329",
            "telephone_number": "678-254-2333",
            "fax_number": "678-254-2332"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12315 CRABAPPLE RD",
            "address_2": "SUITE 108",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "300046329",
            "telephone_number": "678-254-2333",
            "fax_number": "678-254-2332"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BIANCO",
        "first_name": "MICHAEL",
        "middle_name": "THOMAS",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-07-30",
        "last_updated": "2014-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "25MB09009700",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "67533",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Alpharetta, GA

Sources for this page

Verify at the official NPI Registry.