Individual provider Active NPI

Paul David Feldman, M.D.

  • Plastic Surgery Physician
  • Fayetteville, GA
National Provider Identifier
1588656367
Registry record updated Jun 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
License
029640 Issued in GA
Practice address
874 W Lanier Ave
Suite 100
Fayetteville, GA 30214-1511
Phone
(770) 461-4000
Fax
(770) 461-2790
NPI assigned
Aug 18, 2005
Sex
Male
Sole proprietor
No

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.

Care Compare profile

Medicare Care Compare
Specialty
Plastic and Reconstructive Surgery
Education
University of South Florida College of Medicine, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Truffles Vein of Central Georgia LLC 5 clinicians
Truffles Vein Center LLC 14 clinicians

Practice addresses (Care Compare)

874 Lanier Ave W
Suite 220
Fayetteville, GA 30214-7659
Phone (678) 833-1444

96 Vinings Dr
McDonough, GA 30253-5994
Phone (678) 833-1444

Merit-based Incentive Payment System (MIPS)

Final score
7.5 of 100Reported as individual
Quality
15
Improvement activities
0

Procedures performed for Medicare patients

ProcedureNumber of procedures
Varicose vein removal152

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.

Medicare enrollment records 1

Medicare enrollment files
Enrollment IDStateProvider typePAC IDDetails
I20120118000762 GA Practitioner - Plastic and Reconstructive Surgery 7911002001 Reassigns benefits to 3 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Aesthetics, P.C Plastic Surgery CurrentSince May 23, 2000 Accepting new patients
Truffles Vein Center, LLC Plastic Surgery CurrentSince Aug 23, 2012 Accepting new patients
Truffles Vein of Central Georgia LLC CurrentSince Dec 15, 2012 Accepting new patients
Advanced Aesthetics PC CurrentSince May 23, 2000 Accepting new patients

Locations

874 Lanier Ave W
Ste 220
Fayetteville, GA 30214
Phone (678) 833-1444

874 Lanier Ave W
Ste 120
Fayetteville, GA 30214
Phone (678) 833-1444

874 Lanier Ave W
Ste 100
Fayetteville, GA 30214
Phone (770) 461-4000

874 Lanier Ave W
Fayetteville, GA 30214
Phone (770) 683-7873

96 Vinings Dr
McDonough, GA 30253
Phone (678) 833-1444

8 E Court Sq
Newnan, GA 30263
Phone (678) 833-1444

2084 Newnan Crossing Blvd E
Ste 200
Newnan, GA 30265
Phone (770) 461-4000

5041 Dallas Hwy
Ste 107
Powder Springs, GA 30127
Phone (678) 833-1444

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery Physician 208200000X 029640 GA Primary

Addresses

NPPES NPI Registry

Primary practice location

874 W Lanier Ave
Suite 100
Fayetteville, GA 30214-1511

Mailing address

874 W Lanier Ave
Suite 100
Fayetteville, GA 30214-1511
Phone (770) 461-4000

Other identifiers 1

NPPES NPI Registry
IdentifierTypeStateIssuer
00580423AMedicaidGA

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jun 27, 2024.

{
    "created_epoch": "1124323200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719446400000",
    "number": "1588656367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "874 W LANIER AVE",
            "address_2": "SUITE 100",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302141511",
            "telephone_number": "770-461-4000",
            "fax_number": "770-461-2790"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "874 W LANIER AVE",
            "address_2": "SUITE 100",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302141511",
            "telephone_number": "770-461-4000",
            "fax_number": "770-461-2790"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FELDMAN",
        "first_name": "PAUL",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-18",
        "last_updated": "2024-06-27",
        "certification_date": "2024-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "GA",
            "license": "029640",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00580423A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, GA

Sources for this page

Verify at the official NPI Registry.