Individual provider Active NPI

Elizabeth E Richwine, M.D.

  • Dermatology Physician
  • Marietta, GA
National Provider Identifier
1548383292
Registry record updated Dec 7, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
RTP 001901 Issued in GA
Practice address
111 Marble Mill Rd NW
Marietta, GA 30060-1047
Phone
(770) 422-1013
Fax
(770) 514-5996
NPI assigned
Apr 9, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 7, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X RTP 001901 GA Primary

Addresses

Primary practice location

111 Marble Mill Rd NW
Marietta, GA 30060-1047

Mailing address

111 Marble Mill Rd NW
Marietta, GA 30060-1047
Phone (770) 422-1013

Other names 1

  • Dr. Betsy E Richwine Other name

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
I20100722000341 GA Practitioner - Dermatology 8921130212 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Medical College of Georgia School of Medicine, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Marietta Dermatology Associates PAGroup PAC ID 6507850120, 22 clinicians

Practice addresses (Care Compare)

111 Marble Mill NWRD
Marietta, GA 30060-1047

111 Marble Mill Rd NW
Marietta, GA 30060-1047
Phone (770) 422-1013

130 Oakside CT
Suite a
Canton, GA 30114-2456
Phone (770) 422-1013

5041 Dallas Hwy
Suite D
Powder Springs, GA 30127-6458
Phone (770) 422-1013

Merit-based Incentive Payment System (MIPS)

Final score
83.26 of 100Reported as individual
Quality
72.29
Promoting interoperability
95
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of skin lesions1351
Removal or shaving of skin growth40
Skin biopsy1022

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RTP 001901GAMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Marietta Dermatology Associates PA Dermatology CurrentSince Sep 1, 2010 Accepting new patients

Locations

130 Oakside Ct
Ste A
Canton, GA 30114
Phone (770) 422-1013

111 Marble Mill Rd NW
Marietta, GA 30060
Phone (770) 422-1013

840 Church St NE
Ste A1
Marietta, GA 30060
Phone (770) 428-5988

5041 Dallas Hwy
Ste 209
Powder Springs, GA 30127

5041 Dallas Hwy
Ste D
Powder Springs, GA 30127
Phone (770) 422-1013

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": "1176076800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1323216000000",
    "number": "1548383292",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 MARBLE MILL RD NW",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300601047",
            "telephone_number": "770-422-1013",
            "fax_number": "770-514-5996"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 MARBLE MILL RD NW",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300601047",
            "telephone_number": "770-422-1013",
            "fax_number": "770-514-5996"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICHWINE",
        "first_name": "ELIZABETH",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-09",
        "last_updated": "2011-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "GA",
            "license": "RTP 001901",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BETSY",
            "last_name": "RICHWINE",
            "middle_name": "E",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Marietta, GA

Sources for this page

Verify at the official NPI Registry.