Active NPI
Michael John Koriwchak, M.D.
- Otolaryngology Physician
- Atlanta, GA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Otolaryngology Physician
- License
- 040130
- Practice address
- 5673 Peachtree Dunwoody Rd
Ste 150
Atlanta, GA 30342-1731 - Phone
- (404) 297-1780
- Fax
- (404) 252-7255
- NPI assigned
- Jul 6, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Otolaryngology Physician | 207Y00000X | 040130 | GA | Primary |
| Sleep Medicine (Otolaryngology) Physician | 207YS0012X | 040130 | GA |
Addresses
Primary practice location
5673 Peachtree Dunwoody Rd
Ste 150
Atlanta, GA 30342-1731
Mailing address
5673 Peachtree Dunwoody Rd
Ste 150
Atlanta, GA 30342-1731
Phone (404) 297-1780
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00663935AF | Medicaid | GA | |
| 5576015 | Other | GA | AETNA |
| 52448442 | Other | GA | BCBS OF GEORGIA |
| 8306705 | Other | GA | CIGNA |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Otolaryngology
- Education
- Duke University School of Medicine, 1988
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
5673 Peachtree Dunwoody Rd
Suite 150
Atlanta, GA 30342-1771
Phone (404) 297-4230
748 Old Norcross Rd
Suite 100
Lawrenceville, GA 30046-3394
Phone (770) 339-1500
Hospital & facility affiliations
Merit-based Incentive Payment System (MIPS)
- Final score
- 75 of 100
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Upper gastrointestinal (GI) endoscopy for acid reflux | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 040130 | GA | MD | Sleep Medicine (Otolaryngology) Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Georgia Surgical Professional Services, LLC | Otolaryngology | Current | Accepting new patients |
| ENT of Georgia, LLC | Otolaryngology | Current | Accepting new patients |
| North Atlanta Scan Associates Inc | Past | Accepting new patients |
Locations
550 Peachtree St NE
Ste 1640
Atlanta, GA 30308
Phone (404) 653-0830
748 Old Norcross Rd
Ste 100
Lawrenceville, GA 30046
Phone (404) 297-4230
1000 Johnson Ferry Rd
Sandy Springs, GA 30342
Phone (404) 851-8737
5673 Peachtree Dunwoody Rd
Ste 150
Sandy Springs, GA 30342
Phone (404) 297-4230
1790 Presidential Cir
Ste A
Snellville, GA 30078
Phone (404) 297-4230
Interoperability endpoints
- mkoriwchak@entofga.emadirect.md
Organizations & group practices 3
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.
-
- Otolaryngology Physician
- Atlanta, GA
- NPI 1922046424
-
- Otolaryngology Physician
- Atlanta, GA
- NPI 1801224506
-
dba Open Alpharetta Imaging Center
- Radiology Clinic/Center
- Alpharetta, GA
- NPI 1700826096
Hospital & facility affiliations 3
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Emory Decatur Hospital
- General Acute Care Hospital
- Decatur, GA
- NPI 1093716979
-
dba Northside Hospital
- General Acute Care Hospital
- Atlanta, GA
- NPI 1457396079
-
- General Acute Care Hospital
- Atlanta, GA
- NPI 1679664395
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1120608000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1485907200000",
"number": "1720085756",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5673 PEACHTREE DUNWOODY RD",
"address_2": "STE 150",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303421731",
"telephone_number": "404-297-1780",
"fax_number": "404-252-7255"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5673 PEACHTREE DUNWOODY RD",
"address_2": "STE 150",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303421731",
"telephone_number": "404-297-1780",
"fax_number": "404-252-7255"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KORIWCHAK",
"first_name": "MICHAEL",
"middle_name": "JOHN",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-07-06",
"last_updated": "2017-02-01",
"status": "A"
},
"taxonomies": [
{
"code": "207Y00000X",
"taxonomy_group": "",
"desc": "Otolaryngology",
"state": "GA",
"license": "040130",
"primary": true
},
{
"code": "207YS0012X",
"taxonomy_group": "",
"desc": "Otolaryngology, Sleep Medicine",
"state": "GA",
"license": "040130",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00663935AF",
"state": "GA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "5576015",
"state": "GA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS OF GEORGIA",
"identifier": "52448442",
"state": "GA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA",
"identifier": "8306705",
"state": "GA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Atlanta, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2017; 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.