Michael A. Bakarich, D.O.
Individual provider Active NPI Gynecology Physician · Lagrange, GA
NPI 1699790071 · NPPES record last updated Aug 18, 2022
Key facts
- NPI
- 1699790071
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Gynecology Physician 207VG0400X
- License
- 060793 (GA)
- Practice address
- 1602 Vernon Rd Ste 200
Lagrange, GA 30240-4129 - Phone
- (706) 880-7252
- Fax
- (770) 999-2687
- NPI assigned
- Jul 13, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 4
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Obstetrics/Gynecology
- Education
- Midwestern University, Chicago College of Osteopathic Med, 1999
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Wellstar Medical Group LLC
Practice addresses (Care Compare)
1510 Vernon Rd
Lagrange, GA 30240-4131
Phone (706) 845-3905
1514 Vernon Rd
Lagrange, GA 30240-4131
Phone (706) 880-7222
1600 Vernon Rd
Lagrange, GA 30240-4143
2000 Billy Tucker Cir
Hogansville, GA 30230-2793
Phone (706) 880-7222
5150 Stilesboro N W Rd
Suite 220
Kennesaw, GA 30152-7742
Phone (770) 424-8222
Hospital & facility affiliations
- Wellstar West Georgia Medical Center
Merit-based Incentive Payment System (MIPS)
- Final score
- 93.93 of 100
- Quality
- 82.14
- Promoting interoperability
- 100
- Improvement activities
- 40
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal or shaving of skin growth | 1-10 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in GA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20080709000579 | GA | Practitioner - Obstetrics/Gynecology | 3779527833 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 02655 | KY | MD | Obstetrics & Gynecology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Wellstar Medical Group, LLC | Current |
Accepting new patients | |
| Gynecology & Obstetrics Professional Group of West Georgia PC | Current | Accepting new patients | |
| Wellstar Medical Group, LLC | Current | Accepting new patients | |
| West Georgia Medical Center, Inc. | Past | Accepting new patients |
Locations
5150 Stilesboro Rd NW
Ste 220
Kennesaw, GA 30152
Phone (770) 424-8222
1602 Vernon Rd
Ste 200
Lagrange, GA 30240
Phone (478) 292-7962
1600 Vernon Rd
Ste D
Lagrange, GA 30240
Phone (412) 999-3638
805 Sandy Plains Rd
Marietta, GA 30066
Phone (770) 792-1616
Interoperability endpoints
- mbakarich491261@directwellstar.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Obstetrics & Gynecology Physician | 207V00000X | 02655 | KY | |
| Gynecology Physician | 207VG0400X | 060793 | GA | Yes |
| Obstetrics & Gynecology Physician | 207V00000X | 060793 | GA |
Addresses
Primary practice location
1602 Vernon Rd Ste 200
Lagrange, GA 30240-4129
Mailing address
1602 Vernon Rd Ste 200
Lagrange, GA 30240-4129
Phone (706) 880-7252
Other practice location 1
775 Poplar Rd Ste 120
Newnan, GA 30265-8301
Phone (770) 400-4523
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 060793 | Other | GA | GA LIC # |
| 1224988 | Other | KY | CHA |
| 000000369572 | Other | KY | ANTHEN BC/BS |
| 104792175A | Medicaid | GA | |
| 64023674 | Medicaid | KY | |
| 7238699 | Other | KY | AETNA HEALTH INS. |
| 364489332 | Other | TAX I.D. NUMBER FOR RWHC |
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | mbakarich491261@directwellstar.org | Health Information Exchange (HIE) |
Other providers in Lagrange, GA
- Back to Life Chiropractic Center Inc
- Coney Bae
- Kevin Baerwalde
- Alyssa Bagley
- Cassandra Michelle Bailey
- George W Baker Jr.
- Balanced Health Consultants, LLC
- Michele Marie Ballister
- Debra Denise Banks
- Rhonda Rena Barber
All providers in Lagrange, GA · Gynecology Physician in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 18, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.