Leiv M Takle Jr., MD

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

057850 Issued in GA

Practice address

646 S 8TH St
Griffin, GA 30224-4214

Phone

(770) 228-3836

NPI assigned

Jul 6, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Specialty

Ophthalmology

Education

Other, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Leiv M Takle MD PCGroup PAC ID 2062400286, 5 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Wellstar Spalding Medical Center Hospital, Griffin, GA, CCN 110031

Merit-based Incentive Payment System (MIPS)

Final score

90.66 of 100Reported as group

Quality

91.2

Improvement activities

40

Cost

80.61

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
• Direct secure messaging: leiv.taklejr.p1@direct.teg.nextgenshare.com

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.

• Leiv M Takle MD PC

  • Ophthalmology Physician
  • Griffin, GA
  • NPI 1568665404
  Medicare reassignment Care Compare group NPD Authorized official
• Takle Eye Surgery Center LLC

  • Ambulatory Surgical Clinic/Center
  • Locust Grove, GA
  • NPI 1740776517
  NPD Authorized official

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

• Wellstar Spalding Regional Hospital, Inc

  • General Acute Care Hospital
  • Griffin, GA
  • NPI 1972535318
  Care Compare affiliation

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

{
    "created_epoch": "1152144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1492992000000",
    "number": "1609807445",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "646 S 8TH ST",
            "city": "GRIFFIN",
            "state": "GA",
            "postal_code": "302244214",
            "telephone_number": "770-228-3836",
            "fax_number": "770-412-1733"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "646 S 8TH ST",
            "city": "GRIFFIN",
            "state": "GA",
            "postal_code": "302244214",
            "telephone_number": "770-228-3836"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAKLE",
        "first_name": "LEIV",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-06",
        "last_updated": "2017-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "GA",
            "license": "057850",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "180697446C",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Superior Eyecare of Griffin
• Superior Eyecare of Madison Inc
• Surgical Clinic of Griffin-Spalding, P.C.
• Holly Sutton, LPN
• Lisa Swain, RN
• Leiv Munlaug Takle, MD
• Nieka Talley
• Tamika Quality Home Health
• Darlene Carnell Tarantine
• Brandee Kamillya Temmis

• Ophthalmology Physician in Griffin, GA
• Providers in Griffin, GA by specialty
• Ophthalmology Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 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.

Verify at the official NPI Registry.