Individual provider Active NPI

Preston Chandler Delaperriere, M.D.

  • Pain Medicine (Anesthesiology) Physician
  • Macon, GA
National Provider Identifier
1699756361
Registry record updated Apr 23, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X
License
36365 Issued in GA
Practice address
3356 Vineville Ave
Macon, GA 31204-2328
Phone
(478) 476-9642
Fax
(478) 476-9976
NPI assigned
Nov 9, 2005
Last updated
Apr 23, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Anesthesiology) Physician 207LP2900X 36365 GA Primary

Addresses

Primary practice location

3356 Vineville Ave
Macon, GA 31204-2328

Mailing address

3356 Vineville Ave
Macon, GA 31204-2328
Phone (478) 476-9642

Other identifiers 1

IdentifierTypeStateIssuer
00647072AMedicaidGA

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
I20100830000399 GA Practitioner - AnesthesiologyPractitioner - Pain Management 4587623533 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
AnesthesiologyAlso: Pain Management
Education
Medical College of Georgia School of Medicine, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Georgia Pain Institute. LLCGroup PAC ID 1557254844, 5 clinicians

Practice addresses (Care Compare)

3356 Vineville Ave
Macon, GA 31204-2328
Phone (478) 476-9642

Merit-based Incentive Payment System (MIPS)

Final score
26.92 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
89.75

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Georgia Pain Institute. LLC CurrentSince Apr 1, 2013 Accepting new patients
Macon Pain Center, P.C. Current Accepting new patients
Lighthouse Anesthesia LLC Past Accepting new patients
Middle Georgia Anesthesia Associates, PC Pain Medicine Past Accepting new patients
Anesthesia Associates of Savannah ,PA Past Accepting new patients

Locations

3356 Vineville Ave
Macon, GA 31204
Phone (478) 476-9642

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1131494400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1366675200000",
    "number": "1699756361",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3356 VINEVILLE AVE",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312042328",
            "telephone_number": "478-476-9642",
            "fax_number": "478-476-9976"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3356 VINEVILLE AVE",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312042328",
            "telephone_number": "478-476-9642",
            "fax_number": "478-476-9976"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DELAPERRIERE",
        "first_name": "PRESTON",
        "middle_name": "CHANDLER",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-09",
        "last_updated": "2013-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "GA",
            "license": "36365",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00647072A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Macon, GA

Sources for this page

Verify at the official NPI Registry.