Praya Mam, D.P.M.

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

License

00723 Issued in GA

Practice address

4877 Bill Gardner Pkwy
Locust Grove, GA 30248

Phone

(404) 363-9944

Fax

(678) 432-7040

NPI assigned

Dec 23, 2005

Last updated

Jul 23, 2018By 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 1

Addresses

Other identifiers 1

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: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Podiatry

Education

Kent State University College of Podiatric Medicine, 1992

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

American Foot and Leg Specialists, P.C.Group PAC ID 9436140555, 7 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Northside Hospital Hospital, Atlanta, GA, CCN 110161

Merit-based Incentive Payment System (MIPS)

Final score

93.93 of 100Reported as apm

Quality

82.14

Promoting interoperability

100

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• American Foot & Leg Specialists, P.C.

  • Foot & Ankle Surgery Podiatrist
  • Forest Park, GA
  • NPI 1740324037
  Medicare reassignment Care Compare group NPD
• American Foot & Leg Specialists, P.C.

  dba Ambulatory Laser & Surgery Center

  • Ambulatory Surgical Clinic/Center
  • Forest Park, GA
  • NPI 1730360264
  NPD

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

• Northside Hospital, Inc.

  dba Northside Hospital

  • General Acute Care Hospital
  • Atlanta, GA
  • NPI 1457396079
  Care Compare affiliation

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

{
    "created_epoch": "1135296000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1532304000000",
    "number": "1710964408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "425 FOREST PKWY",
            "address_2": "SUITE 101",
            "city": "FOREST PARK",
            "state": "GA",
            "postal_code": "302972185",
            "telephone_number": "404-363-9944",
            "fax_number": "404-363-9951"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4877 BILL GARDNER PKWY",
            "city": "LOCUST GROVE",
            "state": "GA",
            "postal_code": "30248",
            "telephone_number": "404-363-9944",
            "fax_number": "678-432-7040"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "425 Forest Pkwy",
            "address_2": "Suite 101",
            "address_purpose": "LOCATION",
            "city": "Forest Park",
            "state": "GA",
            "postal_code": "302972185",
            "country_code": "US",
            "telephone_number": "404-363-9944",
            "fax_number": "404-363-9951",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1109 Eagles Landing Pkwy",
            "address_purpose": "LOCATION",
            "city": "Stockbridge",
            "state": "GA",
            "postal_code": "302816394",
            "country_code": "US",
            "telephone_number": "404-363-9944",
            "fax_number": "770-507-8706",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "425 Forest Pkwy Ste 101",
            "address_purpose": "LOCATION",
            "city": "Forest Park",
            "state": "GA",
            "postal_code": "302972135",
            "country_code": "US",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MAM",
        "first_name": "PRAYA",
        "name_prefix": "Dr.",
        "credential": "D.P.M.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-23",
        "last_updated": "2018-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "GA",
            "license": "00723",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00614105A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Foot & Ankle Surgery Podiatrist in Locust Grove, GA
• Providers in Locust Grove, GA by specialty
• Foot & Ankle Surgery Podiatrist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2018; 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.