Individual provider Active NPI

Konstantinos D Anastasiades, MD

  • Anatomic Pathology & Clinical Pathology Physician
  • Atlanta, GA
National Provider Identifier
1831150044
Registry record updated Aug 3, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
026435 Issued in GA
Practice address
303 Parkway Dr NE
Pathology Dept
Atlanta, GA 33120
Phone
(404) 522-0414
Fax
(404) 521-9254
NPI assigned
Mar 29, 2006
Last updated
Aug 3, 2009By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 3, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 026435 GA Primary

Addresses

Primary practice location

303 Parkway Dr NE
Pathology Dept
Atlanta, GA 33120

Mailing address

315 Boulevard St
#240
Atlanta, GA 30312
Phone (404) 522-0414

Other identifiers 1

IdentifierTypeStateIssuer
0036449313MedicaidGA

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
I20101026001449 GA Practitioner - Pathology 0840484531 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
University of Florida College of Medicine, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Metroderm, P.C.Group PAC ID 8729076443, 33 clinicians

Practice addresses (Care Compare)

875 Johnson Ferry Rd
Suite 300
Atlanta, GA 30342-1418
Phone (404) 778-6153

Merit-based Incentive Payment System (MIPS)

Final score
93.93 of 100Reported as apm
Quality
82.14
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Metroderm, P.C. CurrentSince Aug 1, 2017 Accepting new patients
Metroderm, P.C. CurrentSince Aug 1, 2017 Accepting new patients
Atlanta Pathology PA Past Accepting new patients

Locations

875 Johnson Fy Rd NE
Ste 300
Sandy Springs, GA 30342
Phone (404) 257-9933

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, 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": "1143590400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1249257600000",
    "number": "1831150044",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "315 BOULEVARD ST",
            "address_2": "#240",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "30312",
            "telephone_number": "404-522-0414",
            "fax_number": "404-521-9254"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "303 PARKWAY DR NE",
            "address_2": "PATHOLOGY DEPT",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "33120",
            "telephone_number": "404-522-0414",
            "fax_number": "404-521-9254"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANASTASIADES",
        "first_name": "KONSTANTINOS",
        "middle_name": "D",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-29",
        "last_updated": "2009-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "GA",
            "license": "026435",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0036449313",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.