Individual provider Active NPI

Jose Pablo Stolovitzky, M.D.

  • Otolaryngology Physician
  • Atlanta, GA
National Provider Identifier
1558368415
Registry record updated Feb 1, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
029536 Issued in GA
Practice address
5673 Peachtree Dunwoody Rd
Ste 150
Atlanta, GA 30342-1731
Phone
(404) 297-1780
Fax
(404) 252-7255
NPI assigned
Jul 6, 2005
Last updated
Feb 1, 2017By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 1, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X 029536 GA Primary
Sleep Medicine (Otolaryngology) Physician 207YS0012X 029536 GA

Addresses

Primary practice location

5673 Peachtree Dunwoody Rd
Ste 150
Atlanta, GA 30342-1731

Mailing address

5673 Peachtree Dunwoody Rd
Ste 150
Atlanta, GA 30342-1731
Phone (404) 297-1780

Other identifiers 7

IdentifierTypeStateIssuer
000442714ATMedicaidGA
3969952OtherGACIGNA
000442714AQMedicaidGA
52530801OtherGABCBS OF GEORGIA
000442714AGMedicaidGA
400117110OtherGARAILROAD MEDICARE
4134024OtherGAAETNA

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
I20080929000208 GA Practitioner - Otolaryngology 7517850167 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
Other, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
ENT of Georgia, LLCGroup PAC ID 1557254109, 12 clinicians
Georgia Surgical Professional Services LLCGroup PAC ID 3375774011, 38 clinicians

Practice addresses (Care Compare)

5673 Peachtree Dunwoody Rd
Suite 150
Atlanta, GA 30342-1771
Phone (404) 297-4230

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
029536GAMDSleep Medicine (Otolaryngology) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Georgia Surgical Professional Services, LLC Otolaryngology CurrentSince Mar 1, 2014 Accepting new patients
North Atlanta Scan Associates Inc Past Accepting new patients

Locations

550 Peachtree St NE
Ste 1640
Atlanta, GA 30308
Phone (404) 653-0830

484 Irvin Ct
Ste 140
Decatur, GA 30030
Phone (404) 297-1785

748 Old Norcross Rd
Ste 100
Lawrenceville, GA 30046
Phone (404) 297-4230

5673 Peachtree Dunwoody Rd
Ste 150
Sandy Springs, GA 30342
Phone (404) 297-4230

1790 Presidential Cir
Ste A
Snellville, GA 30078
Phone (404) 297-4230

Interoperability endpoints

  • Direct secure messaging: jstolovitzky4665@choa.gadirect.net
  • Direct secure messaging: pstol@entofga.emadirect.md

Organizations & group practices 3

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1120608000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1485907200000",
    "number": "1558368415",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5673 PEACHTREE DUNWOODY RD",
            "address_2": "STE 150",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303421731",
            "telephone_number": "404-297-1780",
            "fax_number": "404-252-7255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5673 PEACHTREE DUNWOODY RD",
            "address_2": "STE 150",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303421731",
            "telephone_number": "404-297-1780",
            "fax_number": "404-252-7255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STOLOVITZKY",
        "first_name": "JOSE",
        "middle_name": "PABLO",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-06",
        "last_updated": "2017-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "GA",
            "license": "029536",
            "primary": true
        },
        {
            "code": "207YS0012X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Sleep Medicine",
            "state": "GA",
            "license": "029536",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000442714AT",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "3969952",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000442714AQ",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF GEORGIA",
            "identifier": "52530801",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000442714AG",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "400117110",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "4134024",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.