Active NPI
Eduardo J. Olmedo, M.D.
- Orthopaedic Surgery Physician
- Austell, GA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthopaedic Surgery Physician
- License
- 034036
- Practice address
- 2041 Mesa Valley Way
Suite 100
Austell, GA 30106-8157 - Phone
- (770) 944-1100
- Fax
- (770) 944-6469
- NPI assigned
- Oct 4, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthopaedic Surgery Physician | 207X00000X | 034036 | GA | Primary |
Addresses
Primary practice location
2041 Mesa Valley Way
Suite 100
Austell, GA 30106-8157
Mailing address
2041 Mesa Valley Way
Suite 100
Austell, GA 30106-8157
Phone (770) 944-1100
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000457058H | Medicaid | GA | |
| 000457058C | Medicaid | GA | |
| 000457058F | Medicaid | GA | |
| 000457058B | Medicaid | GA |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Orthopedic Surgery
- Education
- University of Puerto Rico School of Medicine, 1983
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1700 Hospital S Dr
Austell, GA 30106-8159
3950 Austell Rd
Austell, GA 30106-1121
Phone (770) 732-4022
5150 Stilesboro N W Rd
Suite 220
Kennesaw, GA 30152-7742
Phone (770) 424-8222
8954 Hospital Dr
Douglasville, GA 30134-2272
Phone (678) 838-2585
Hospital & facility affiliations
- Wellstar Douglas Medical Center
- Wellstar Cobb Medical Center
- Wellstar Kennestone Regional Medical Center
- Wellstar Windy Hill Hospital
Merit-based Incentive Payment System (MIPS)
- Final score
- 93.93 of 100
- Quality
- 82.14
- Promoting interoperability
- 100
- Improvement activities
- 40
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Lower limb (leg) arthroscopy (minimally invasive joint repair) | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 034036 | GA | MD | Orthopaedic Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Wellstar Medical Group, LLC | Current | Accepting new patients | |
| Wellstar Medical Group, LLC | Current | Accepting new patients | |
| Smyrna Orthopaedic & Sports Medicine Center, PC | Orthopaedic Surgery | Past | Accepting new patients |
| Resurgens, LLC | Orthopaedic Surgery | Past | Accepting new patients |
Locations
1700 Hospital South Dr
Ste 502
Austell, GA 30106
Phone (770) 739-9555
8901 Stonebridge Blvd
Ste 200
Douglasville, GA 30134
Phone (943) 202-7030
5150 Stilesboro Rd NW
Ste 220
Kennesaw, GA 30152
Phone (770) 424-8222
582 Concord Rd SE
Ste C
Smyrna, GA 30082
Phone (404) 436-5484
Interoperability endpoints
- eduardo.olmedo.1@15749.direct.athenahealth.com
Organizations & group practices 4
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.
-
dba WellStar Family Medicine ACW
- Family Medicine Physician
- Kennesaw, GA
- NPI 1558664003
-
- Multi-Specialty Clinic/Center
- Marietta, GA
- NPI 1275992240
-
- Clinic/Center
- Smyrna, GA
- NPI 1740305721
Orthopaedic Surgery
Hospital & facility affiliations 4
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Wellstar Cobb Hospital
- General Acute Care Hospital
- Austell, GA
- NPI 1467420448
-
dba Wellstar Douglas Hospital
- General Acute Care Hospital
- Douglasville, GA
- NPI 1649247974
-
dba Wellstar Kennestone Hospital
- General Acute Care Hospital
- Marietta, GA
- NPI 1649248626
-
dba Wellstar Windy Hill Hospital
- Long Term Care Hospital
- Marietta, GA
- NPI 1700853041
Long-term care hospital
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1128384000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1484092800000",
"number": "1588651632",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2041 MESA VALLEY WAY",
"address_2": "SUITE 100",
"city": "AUSTELL",
"state": "GA",
"postal_code": "301068157",
"telephone_number": "770-944-1100",
"fax_number": "770-944-6469"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2041 MESA VALLEY WAY",
"address_2": "SUITE 100",
"city": "AUSTELL",
"state": "GA",
"postal_code": "301068157",
"telephone_number": "770-944-1100",
"fax_number": "770-944-6469"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OLMEDO",
"first_name": "EDUARDO",
"middle_name": "J.",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-10-04",
"last_updated": "2017-01-11",
"status": "A"
},
"taxonomies": [
{
"code": "207X00000X",
"taxonomy_group": "",
"desc": "Orthopaedic Surgery",
"state": "GA",
"license": "034036",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "000457058H",
"state": "GA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "000457058C",
"state": "GA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "000457058F",
"state": "GA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "000457058B",
"state": "GA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Austell, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.