Michael Rollock, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY003572 Issued in GA

Practice address

997 Saint Sebastian Way
Augusta, GA 30912-2613

Phone

(706) 721-6719

NPI assigned

Oct 6, 2009

Last updated

Apr 12, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

University of Massachusetts Medical School, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Wellstar Medical Group LLCGroup PAC ID 6709065402, 3,059 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Wellstar MCG Health, Affiliated With Med Col Hospital, Augusta, GA, CCN 110034

Merit-based Incentive Payment System (MIPS)

Final score

93.93 of 100Reported as apm

Quality

82.14

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

Practice roles

Locations

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.

• Wellstar Medical Group, LLC

  dba WellStar Family Medicine ACW

  • Family Medicine Physician
  • Kennesaw, GA
  • NPI 1558664003
  Medicare reassignment Care Compare group NPD
• Au Medical Associates Anesthesia Billing Services, LLC

  dba MCG Anesthesiology Financial Services

  • Anesthesiology Physician
  • Augusta, GA
  • NPI 1801843933
  Medicare reassignment NPD
• Augusta University

  • Hospitalist Physician
  • Augusta, GA
  • NPI 1760559124
  Medicare reassignment NPD
• Wellstar Medical Group, LLC

  • Multi-Specialty Clinic/Center
  • Marietta, GA
  • NPI 1275992240
  NPD

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

• Au Medical Center, Inc

  • General Acute Care Hospital
  • Augusta, GA
  • NPI 1437135902
  Care Compare affiliation

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

{
    "created_epoch": "1254787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681257600000",
    "number": "1629303870",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "997 SAINT SEBASTIAN WAY",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309122613",
            "telephone_number": "706-721-6719"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "997 SAINT SEBASTIAN WAY",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309122613",
            "telephone_number": "706-721-6719"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1120 15th St",
            "address_purpose": "LOCATION",
            "city": "Augusta",
            "state": "GA",
            "postal_code": "309123815",
            "country_code": "US",
            "telephone_number": "706-721-8623",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3405 Mike Padgett Hwy",
            "address_purpose": "LOCATION",
            "city": "Augusta",
            "state": "GA",
            "postal_code": "309063815",
            "country_code": "US",
            "telephone_number": "706-792-7126",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROLLOCK",
        "first_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-10-06",
        "last_updated": "2023-04-12",
        "certification_date": "2023-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207LA0401X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Addiction Medicine",
            "state": "GA",
            "license": "PSY003572",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "GA",
            "license": "PSY003572",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Psychologist in Augusta, GA
• Providers in Augusta, GA by specialty
• Clinical Psychologist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2023; 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.