Individual provider Active NPI

Piyush Raman

  • Dermatology Physician
  • Marietta, GA
National Provider Identifier
1558471201
Registry record updated Jun 21, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
059924 Issued in GA
Practice address
111 Marble Mill Rd NW
Marietta, GA 30060-1047
Phone
(770) 422-1013
NPI assigned
Aug 30, 2006
Last updated
Jun 21, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2012

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 059924 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 identifiers 1

IdentifierTypeStateIssuer
059924OtherGASTATE LICENSE

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
I20080205000126 GA Practitioner - Dermatology 2163433160 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Kansas City College of Medicine and Surgery, 2000
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
83.98 of 100Reported as individual
Quality
71.96
Promoting interoperability
98
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision42
Removal of skin lesions2973
Removal or shaving of skin growth27
Skin biopsy1282

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Marietta Dermatology Associates PA Dermatology CurrentSince Jan 2, 2008 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

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, 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": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1340236800000",
    "number": "1558471201",
    "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"
        },
        {
            "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"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAMAN",
        "first_name": "PIYUSH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-30",
        "last_updated": "2012-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "GA",
            "license": "059924",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "059924",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Marietta, GA

Sources for this page

Verify at the official NPI Registry.