Individual provider Active NPI

John L Oprysko, D.O.

  • Family Medicine Physician
  • Tucker, GA
National Provider Identifier
1700849874
Registry record updated Oct 20, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
034211 Issued in GA
Practice address
4445 Cowan Rd
Tucker, GA 30084-4829
Phone
(770) 938-0275
Fax
(770) 939-6225
NPI assigned
Apr 10, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 20, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 034211 GA Primary

Addresses

Primary practice location

4445 Cowan Rd
Tucker, GA 30084-4829

Mailing address

4445 Cowan Rd
Tucker, GA 30084-4829
Phone (770) 938-0275

Other identifiers 1

IdentifierTypeStateIssuer
00476616BMedicaidGA

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
I20120309000099 GA Practitioner - Family Practice 5890954903 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
New York College of Osteo Medicine of New York Institute of Technology, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Qcpi-Villagemd PCGroup PAC ID 8123389277, 76 clinicians

Practice addresses (Care Compare)

1805 Parke Plaza Cir
Suite 101
Stone Mountain, GA 30087-3646
Phone (770) 879-0436

5435 Five Forks Trickum Rd
Stone Mountain, GA 30087-3045
Phone (770) 369-9954

Hospital & facility affiliations

  • Piedmont Eastside Medical Center Hospital, Snellville, GA, CCN 110192
  • Emory Decatur Hospital Hospital, Decatur, GA, CCN 110076
  • Northside Hospital Gwinnett Hospital, Lawrenceville, GA, CCN 110087
  • Northside Hospital Hospital, Atlanta, GA, CCN 110161

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Tucker Medical Center P.C. Family Medicine CurrentSince Feb 23, 1993 Accepting new patients

Locations

4445 Cowan Rd
Tucker, GA 30084
Phone (770) 938-0275

Interoperability endpoints

  • Direct secure messaging: john.oprysko.1@21533.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/23796/brand/1/csg/1/fhir/r4

Organizations & group practices 2

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 4

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": "1144627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1287532800000",
    "number": "1700849874",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4445 COWAN RD",
            "city": "TUCKER",
            "state": "GA",
            "postal_code": "300844829",
            "telephone_number": "770-938-0275",
            "fax_number": "770-939-6225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4445 COWAN RD",
            "city": "TUCKER",
            "state": "GA",
            "postal_code": "300844829",
            "telephone_number": "770-938-0275",
            "fax_number": "770-939-6225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OPRYSKO",
        "first_name": "JOHN",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-04-10",
        "last_updated": "2010-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "034211",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00476616B",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucker, GA

Sources for this page

Verify at the official NPI Registry.