Albert Teiko Tagoe, M.D.

Primary specialty

Vascular Surgery PhysicianTaxonomy code 2086S0129X

License

033720 Issued in GA

Practice address

150 Country Club Dr Ste 100
Stockbridge, GA 30281-9089

Phone

(770) 474-3882

Fax

(404) 420-2091

NPI assigned

Mar 31, 2006

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

Other identifiers 2

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Morehouse Healthcare, Inc.

  • Cardiovascular Disease Physician
  • Atlanta, GA
  • NPI 1801832324
  NPD (past)

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

{
    "created_epoch": "1143763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709683200000",
    "number": "1639130453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 COUNTRY CLUB DR STE 100",
            "city": "STOCKBRIDGE",
            "state": "GA",
            "postal_code": "302819089",
            "telephone_number": "770-474-3882",
            "fax_number": "770-474-9392"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 COUNTRY CLUB DR STE 100",
            "city": "STOCKBRIDGE",
            "state": "GA",
            "postal_code": "302819089",
            "telephone_number": "770-474-3882",
            "fax_number": "404-420-2091"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAGOE",
        "first_name": "ALBERT",
        "middle_name": "TEIKO",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-31",
        "last_updated": "2024-03-06",
        "certification_date": "2024-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "GA",
            "license": "33720",
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "GA",
            "license": "033720",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000443198D",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00443198C",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sydal Enterprises, LLC
• Gayla Denise Sylvain, MD
• Syntax Healthcare Inc
• Jocelyn Howard Sysko, AU.D.
• T J Care LLC
• Asif N Tahir, MD
• John Theodore Tallent, SLP
• John Talley
• Cathy Fleurette Tankoua
• Tara Dermatology Center PC

• Vascular Surgery Physician in Stockbridge, GA
• Providers in Stockbridge, GA by specialty
• Vascular Surgery Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2024; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.