Individual provider Active NPI

Peter Bemis H'Doubler Jr., M.D.

  • Vascular Surgery Physician
  • Atlanta, GA
National Provider Identifier
1629038476
Registry record updated Apr 1, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
034609 Issued in GA
Practice address
5673 Peachtree Dunwoody Rd NE
Suite 675
Atlanta, GA 30342-1731
Phone
(678) 843-5400
Fax
(678) 843-5449
NPI assigned
Mar 24, 2006
Last updated
Apr 1, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Surgery Physician 2086S0129X 034609 GA Primary

Addresses

Primary practice location

5673 Peachtree Dunwoody Rd NE
Suite 675
Atlanta, GA 30342-1731

Mailing address

1838 American Way
Lawrenceville, GA 30043-6611
Phone (770) 995-7622

Other identifiers 11

IdentifierTypeStateIssuer
000460039RMedicaidGA
000460039NMedicaidGA
000460039OMedicaidGA
000460039QMedicaidGA
000460039MMedicaidGA
000460039PMedicaidGA
000460039KMedicaidGA
000460039LMedicaidGA
000460039IMedicaidGA
000460039JMedicaidGA
00460039EMedicaidGA

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
I20080624000774 GA Practitioner - Vascular Surgery 0042244063 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Vascular Surgery
Education
Harvard Medical School, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
The Emory Clinic IncGroup PAC ID 8820901408, 3,507 clinicians

Practice addresses (Care Compare)

1365 Clifton Rd NE
Atlanta, GA 30322-1013
Phone (404) 778-7525

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94.51 of 100Reported as apm
Quality
80.61
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Varicose vein removal113
Leg revascularization (restoring blood flow)37

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Emory Medical Care Foundation Inc Current Accepting new patients
Emory Medical Care Foundation Inc CurrentSince Nov 1, 2015 Accepting new patients
The Emory Clinic Inc CurrentSince Sep 1, 2014 Accepting new patients
Emory Specialty Associates, LLC CurrentSince Jan 1, 2012 Accepting new patients
Emory Medical Care Foundation CurrentSince Nov 1, 2015 Accepting new patients
Vein Innovations Past Accepting new patients
St. Joseph's Hospital Past Accepting new patients
Emory Health Care Past Accepting new patients
Saint Josephs Hospital of Atlanta Inc Past Accepting new patients
Ozarks Medical Center Past Accepting new patients

Locations

1365 Clifton Rd NE
Atlanta, GA 30322
Phone (404) 778-7525

1821 Clifton Rd NE
Atlanta, GA 30329
Phone (404) 728-6812

80 Jesse Hill Jr Dr SE
Atlanta, GA 30303
Phone (404) 616-4370

101 W Ponce de Leon Ave
Decatur, GA 30030
Phone (404) 778-4889

79 Southside Church St
Ellijay, GA 30540
Phone 7062764741457

5669 Ptree Dunwoody Rd NE
Sandy Springs, GA 30342
Phone (404) 252-8377

5669 Ptree Dunwoody Rd NE
Ste 100
Sandy Springs, GA 30342
Phone (404) 255-1161

5673 Peachtree Dunwoody Rd
Ste 320
Sandy Springs, GA 30342
Phone (404) 855-5660

5673 Peachtree Dunwoody Rd
Ste 340
Sandy Springs, GA 30342
Phone (678) 731-9815

5673 Peachtree Dunwoody Rd
Ste 675
Sandy Springs, GA 30342
Phone (678) 843-5400

Interoperability endpoints

  • Direct secure messaging: phdoubler41431@direct.emory.org

Organizations & group practices 10

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 3

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": "1143158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1364774400000",
    "number": "1629038476",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1838 AMERICAN WAY",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300436611",
            "telephone_number": "770-995-7622",
            "fax_number": "770-995-7854"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5673 PEACHTREE DUNWOODY RD NE",
            "address_2": "SUITE 675",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303421731",
            "telephone_number": "678-843-5400",
            "fax_number": "678-843-5449"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "H'DOUBLER",
        "first_name": "PETER",
        "middle_name": "BEMIS",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-24",
        "last_updated": "2013-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "GA",
            "license": "034609",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000460039R",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000460039N",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000460039O",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000460039Q",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000460039M",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000460039P",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000460039K",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000460039L",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000460039I",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000460039J",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00460039E",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.