Mark Allan Knautz, MEDICAL DOCTOR

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

041328 Issued in GA

Practice address

5041 Dallas Hwy
Suite D
Powder Springs, GA 30127-6458

Phone

(770) 427-5467

Fax

(770) 427-6340

NPI assigned

May 3, 2006

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 2

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

Specialty

Dermatology

Education

Medical College of Georgia School of Medicine, 1991

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Marietta Dermatology Associates PAGroup PAC ID 6507850120, 22 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

80.91 of 100Reported as individual

Quality

68.03

Promoting interoperability

95

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mknautz@mariettaderm.emadirect.md

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.

• Marietta Dermatology Associates PA

  • Dermatology Physician
  • Marietta, GA
  • NPI 1417007212
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1146614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1323216000000",
    "number": "1790743300",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 MARBLE MILL RD NW",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300601047",
            "telephone_number": "770-422-1013",
            "fax_number": "770-514-5996"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5041 DALLAS HWY",
            "address_2": "SUITE D",
            "city": "POWDER SPRINGS",
            "state": "GA",
            "postal_code": "301276458",
            "telephone_number": "770-427-5467",
            "fax_number": "770-427-6340"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KNAUTZ",
        "first_name": "MARK",
        "middle_name": "ALLAN",
        "name_prefix": "Mr.",
        "credential": "MEDICAL DOCTOR",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-03",
        "last_updated": "2011-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "GA",
            "license": "041328",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "070008625",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "52635067",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tracy Alice Killian, PHARM.D.
• Makayla Shaniece Kinlaw
• Angelo Adam Kisielewicz
• Kleiman LLC
• Klemako Medical Supplies Inc.
• Deja Shari Koenig, NP
• Carolus Korie
• L&D Medical Center, LLC
• Zinny Akunna Lambert, RN
• Afolasade Lawal

• Dermatology Physician in Powder Springs, GA
• Providers in Powder Springs, GA by specialty
• Dermatology Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2011; 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.