Individual provider Active NPI

Patrick Demoss, MD

  • Pediatric Hematology & Oncology Physician
  • Macon, GA
National Provider Identifier
1548654098
Registry record updated Mar 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Hematology & Oncology PhysicianTaxonomy code 2080P0207X
License
98542 Issued in GA
Practice address
770 Pine St Ste 520
Macon, GA 31201-7567
Phone
(478) 633-2694
Fax
(478) 633-4146
NPI assigned
Mar 23, 2015
Last updated
Mar 25, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 25, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Hematology & Oncology Physician 2080P0207X 98542 GA Primary

Addresses

Primary practice location

770 Pine St Ste 520
Macon, GA 31201-7567

Mailing address

770 Pine St Ste 520
Macon, GA 31201-7567
Phone (478) 633-2694

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
I20240329002344 GA Practitioner - Pediatric Medicine 0042527376 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Health Services of Central Georgia, Inc Pediatric Hematology-Oncology CurrentSince Mar 25, 2024 Accepting new patients
The Medical Center of Central Georgia Inc Past Accepting new patients

Locations

770 Pine St
Ste 520
Macon, GA 31201
Phone (478) 633-2694

1120 Morningside Dr
Perry, GA 31069
Phone (478) 218-1706

Interoperability endpoints

  • Direct secure messaging: pdemoss2743596@carolinashealthcaresystem.direct-ci.com

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1427068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711324800000",
    "number": "1548654098",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "770 PINE ST STE 520",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312017567",
            "telephone_number": "478-633-2694",
            "fax_number": "478-633-4146"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "770 PINE ST STE 520",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312017567",
            "telephone_number": "478-633-2694",
            "fax_number": "478-633-4146"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEMOSS",
        "first_name": "PATRICK",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-03-23",
        "last_updated": "2024-03-25",
        "certification_date": "2024-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0207X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Hematology-Oncology",
            "state": "GA",
            "license": "98542",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Macon, GA

Sources for this page

Verify at the official NPI Registry.