Individual provider Active NPI

Thomas C Varughese, M.D

  • Internal Medicine Physician
  • Douglasville, GA
National Provider Identifier
1720138597
Registry record updated Apr 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
045998 Issued in GA
Practice address
6130 Prestley Mill Rd Ste B
Douglasville, GA 30134-2288
Phone
(770) 771-5100
Fax
(770) 771-5101
NPI assigned
Jan 11, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 1, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 045998 GA Primary

Addresses

Primary practice location

6130 Prestley Mill Rd Ste B
Douglasville, GA 30134-2288

Mailing address

6130 Prestley Mill Rd Ste B
Douglasville, GA 30134-2288
Phone (770) 771-5100

Other identifiers 1

IdentifierTypeStateIssuer
000831553CMedicaidGA

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
I20041207000221 GA Practitioner - Internal Medicine 5890751341 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

6130 Prestley Mill Rd
Suite B
Douglasville, GA 30134-2288
Phone (770) 771-5100

Hospital & facility affiliations

  • Centerwell Home Health Home health agency, Peachtree City, GA, CCN 117137
  • Wellstar Douglas Medical Center Hospital, Douglasville, GA, CCN 110184
  • Wellstar Cobb Medical Center Hospital, Austell, GA, CCN 110143
  • Wellstar Paulding Medical Center Hospital, Hiram, GA, CCN 110042
  • Wellstar Kennestone Regional Medical Center Hospital, Marietta, GA, CCN 110035
  • Wellstar Windy Hill Hospital Long-term care hospital, Marietta, GA, CCN 112007

Merit-based Incentive Payment System (MIPS)

Final score
99.99 of 100Reported as individual
Quality
99.98
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal or shaving of skin growth1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Arbor Place Family Medicine Internal Medicine CurrentSince Oct 27, 2004 Accepting new patients
Douglas County Family Practice, P.C. Internal Medicine PastSince Sep 25, 2017 Accepting new patients
Douglas County Family Practice, P.C. Past Accepting new patients

Locations

6095 Professional Pkwy
Ste B200
Douglasville, GA 30134
Phone (404) 321-9900

6130 Prestley Mill Rd
Ste B
Douglasville, GA 30134
Phone (404) 446-1760

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.

Hospital & facility affiliations 6

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": "1168473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617235200000",
    "number": "1720138597",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6130 PRESTLEY MILL RD STE B",
            "city": "DOUGLASVILLE",
            "state": "GA",
            "postal_code": "301342288",
            "telephone_number": "770-771-5100",
            "fax_number": "770-771-5101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6130 PRESTLEY MILL RD STE B",
            "city": "DOUGLASVILLE",
            "state": "GA",
            "postal_code": "301342288",
            "telephone_number": "770-771-5100",
            "fax_number": "770-771-5101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VARUGHESE",
        "first_name": "THOMAS",
        "middle_name": "C",
        "credential": "M.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-11",
        "last_updated": "2021-04-01",
        "certification_date": "2021-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "045998",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000831553C",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Douglasville, GA

Sources for this page

Verify at the official NPI Registry.