Individual provider Active NPI

Osama Bisher Atallah, MD

  • Colon & Rectal Surgery Physician
  • Macon, GA
National Provider Identifier
1629101019
Registry record updated Apr 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Colon & Rectal Surgery PhysicianTaxonomy code 208C00000X
License
103308 Issued in GA
Practice address
380 Hospital Dr Ste 320
Macon, GA 31217-8007
Phone
(478) 750-8606
NPI assigned
Mar 14, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 103308 GA
Colon & Rectal Surgery Physician 208C00000X L5663 TX
Colon & Rectal Surgery Physician 208C00000X ME99433 FL
Colon & Rectal Surgery Physician 208C00000X 103308 GA Primary

Addresses

Primary practice location

380 Hospital Dr Ste 320
Macon, GA 31217-8007

Mailing address

380 Hospital Dr Ste 320
Macon, GA 31217-8007

Other practice location 1

242 Loch Lomond Dr
Winter Park, FL 32792-3316
Phone (407) 303-5191

Other names 1

  • Sam B Atallah Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, GA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20070817000654 FL Practitioner - Colorectal Surgery (Proctology) 2567554728 Reassigns benefits to 2 organizations
I20250418000135 GA Practitioner - Colorectal Surgery (Proctology) 2567554728 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Colorectal Surgery (Proctology)
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Piedmont Providers LLCGroup PAC ID 9830082825, 526 clinicians

Practice addresses (Care Compare)

380 Hospital Dr
Suite 320
Macon, GA 31217-8007
Phone (478) 750-8606

Hospital & facility affiliations

  • Enhabit Home Health Home health agency, Macon, GA, CCN 117152
  • Coliseum Medical Centers, LLC, Dba Hospital, Macon, GA, CCN 110164
  • Piedmont Macon North Hospital Hospital, Macon, GA, CCN 110201

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy20
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
103308GAMDColon & Rectal Surgery Physician
L5663TXMDColon & Rectal Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Hospital Medical Group Inc Surgery CurrentSince Aug 1, 2007 Accepting new patients
Florida Hospital Medical Group Inc CurrentSince Aug 1, 2007 Accepting new patients
Endo-Surgical Center of Florida CurrentSince Sep 1, 2018 Accepting new patients
Piedmont Providers LLC CurrentSince Mar 1, 2025 Accepting new patients

Locations

2600 Westhall Ln
Ste 4
Maitland, FL 32751
Phone (407) 200-2700

100 N Dean Rd
Ste 102
Orlando, FL 32825
Phone (407) 506-0006

100 N Dean Rd
Ste 101
Orlando, FL 32825
Phone (407) 348-7388

100 N Dean Rd
Ste 100
Orlando, FL 32825

242 Loch Lomond Dr
Winter Park, FL 32792
Phone (407) 599-9705

2727 Paces Ferry Rd SE
Ste 1-1100
Atlanta, GA 30339
Phone (470) 271-3421

1984 Peachtree Rd NW
Ste 300
Atlanta, GA 30309
Phone (404) 367-3210

380 Hospital Dr
Ste 320
Macon, GA 31217
Phone (478) 742-5331

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

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.

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": "1173830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745798400000",
    "number": "1629101019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "380 HOSPITAL DR STE 320",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312178007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "380 HOSPITAL DR STE 320",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312178007",
            "telephone_number": "478-750-8606"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "242 Loch Lomond Dr",
            "address_purpose": "LOCATION",
            "city": "Winter Park",
            "state": "FL",
            "postal_code": "327923316",
            "country_code": "US",
            "telephone_number": "407-303-5191",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ATALLAH",
        "first_name": "OSAMA",
        "middle_name": "BISHER",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-14",
        "last_updated": "2025-04-28",
        "certification_date": "2025-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "GA",
            "license": "103308",
            "primary": false
        },
        {
            "code": "208C00000X",
            "taxonomy_group": "",
            "desc": "Colon & Rectal Surgery",
            "state": "TX",
            "license": "L5663",
            "primary": false
        },
        {
            "code": "208C00000X",
            "taxonomy_group": "",
            "desc": "Colon & Rectal Surgery",
            "state": "FL",
            "license": "ME99433",
            "primary": false
        },
        {
            "code": "208C00000X",
            "taxonomy_group": "",
            "desc": "Colon & Rectal Surgery",
            "state": "GA",
            "license": "103308",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SAM",
            "last_name": "ATALLAH",
            "middle_name": "B",
            "credential": "MD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Macon, GA

Sources for this page

Verify at the official NPI Registry.