Individual provider Active NPI

Dominic Ofosu Amakye, MD

  • Internal Medicine Physician
  • Athens, GA
National Provider Identifier
1760045223
Registry record updated Jun 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
92035 Issued in GA
Practice address
1270 Prince Avenue Suite 201
Athens, GA 30606
Phone
(706) 475-7055
NPI assigned
Apr 19, 2019
Reactivated
Jan 6, 2020
Last updated
Jun 22, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Internal Medicine Physician 207R00000X 92035 GA Primary

Addresses

Primary practice location

1270 Prince Avenue Suite 201
Athens, GA 30606

Mailing address

1199 Prince Avenue #70
Athens, GA 30606

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
I20220902000189 GA Practitioner - Internal Medicine 1153719273 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
91.62 of 100Reported as apm
Quality
83.25
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
92035GAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Piedmont Athens Primary Care LLC CurrentSince Jul 1, 2022 Accepting new patients
Piedmont Hospitalist Physicians LLC Internal Medicine CurrentSince Aug 1, 2024 Accepting new patients
Piedmont Athens Hospitalist Physicians LLC Internal Medicine CurrentSince Jul 1, 2022 Accepting new patients
Piedmont Athens Specialty Care LLC Past Accepting new patients
Piedmont Athens Regional Medical Center, Inc. Past Accepting new patients

Locations

1199 Prince Ave
Athens, GA 30606
Phone (706) 354-3520

1199 Prince Ave
#70
Athens, GA 30606
Phone (706) 745-7055

1270 Prince Ave
Ste 201
Athens, GA 30606
Phone (470) 271-3427

35 Collier Rd NW
Ste 635
Atlanta, GA 30309
Phone (404) 367-3000

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1555632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655856000000",
    "number": "1760045223",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1199 PRINCE AVENUE #70",
            "city": "ATHENS",
            "state": "GA",
            "postal_code": "30606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1270 PRINCE AVENUE SUITE 201",
            "city": "ATHENS",
            "state": "GA",
            "postal_code": "30606",
            "telephone_number": "706-475-7055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AMAKYE",
        "first_name": "DOMINIC",
        "middle_name": "OFOSU",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-04-19",
        "last_updated": "2022-06-22",
        "certification_date": "2022-06-22",
        "deactivation_date": "2019-12-04",
        "reactivation_date": "2020-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "92035",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Athens, GA

Sources for this page

Verify at the official NPI Registry.