Individual provider Active NPI

Mark Francis Baucom, M.D.

  • MOHS-Micrographic Surgery Physician
  • Atlanta, GA
National Provider Identifier
1831184357
Registry record updated Dec 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
MOHS-Micrographic Surgery PhysicianTaxonomy code 207ND0101X
License
034773 Issued in GA
Practice address
5555 Peachtree Dunwoody Rd NE
Ste 206
Atlanta, GA 30342-1703
Phone
(404) 844-0496
Fax
(404) 943-9464
NPI assigned
Sep 12, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 13, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
MOHS-Micrographic Surgery Physician 207ND0101X 034773 GA Primary

Addresses

Primary practice location

5555 Peachtree Dunwoody Rd NE
Ste 206
Atlanta, GA 30342-1703

Mailing address

5555 Peachtree Dunwoody Rd
Ste 206
Atlanta, GA 30342-1711
Phone (404) 844-0496

Other practice location 1

10750 Medlock Bridge Rd Ste 101
Johns Creek, GA 30097-1705
Phone (470) 545-2124

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
I20100901000188 GA Practitioner - Dermatology 4981620671 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Emory University School of Medicine, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Baucom and Mina Derm Surgery, LLC.Group PAC ID 5890076236, 3 clinicians

Practice addresses (Care Compare)

5555 Peachtree Dunwoody Rd
Suite 206
Atlanta, GA 30342-1711
Phone (404) 844-0496

Merit-based Incentive Payment System (MIPS)

Final score
94.51 of 100Reported as apm
Quality
80.61
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision235
Removal of skin lesions25
Removal of skin cancer912
Removal of nail tissue1-10
Removal or shaving of skin growth1-10
Skin biopsy119

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
034773GAMDMOHS-Micrographic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dermatology & Skin Surgery Center, P.C. CurrentSince Jun 1, 1993 Accepting new patients
Baucom & Mina Derm Surgery, LLC Mohs-Micrographic Surgery CurrentSince Jan 1, 2016 Accepting new patients
ASC of Georgia Dermatologic Surgery PastSince Dec 17, 2023 Accepting new patients
ASC of Baucom & Mina Derm Surgery Johns Creek LLC PastSince Jun 1, 2023 Accepting new patients

Locations

10750 Medlock Bridge Rd
Ste 101
Johns Creek, GA 30097
Phone (470) 545-2124

5555 Peachtree Dunwoody Rd
Ste 220
Sandy Springs, GA 30342
Phone (404) 844-0496

5555 Peachtree Dunwoody Rd
Ste 206
Sandy Springs, GA 30342
Phone (404) 292-0393

5555 Peachtree Dunwoody Rd
Ste G65
Sandy Springs, GA 30342
Phone (404) 943-1996

210 Village Center Pkwy
Stockbridge, GA 30281
Phone (770) 474-5952

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1126483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702425600000",
    "number": "1831184357",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5555 PEACHTREE DUNWOODY RD",
            "address_2": "STE 206",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303421711",
            "telephone_number": "404-844-0496",
            "fax_number": "404-844-0499"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5555 PEACHTREE DUNWOODY RD NE",
            "address_2": "STE 206",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303421703",
            "telephone_number": "404-844-0496",
            "fax_number": "404-943-9464"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10750 Medlock Bridge Rd Ste 101",
            "address_purpose": "LOCATION",
            "city": "Johns Creek",
            "state": "GA",
            "postal_code": "300971705",
            "country_code": "US",
            "telephone_number": "470-545-2124",
            "fax_number": "404-844-0496",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BAUCOM",
        "first_name": "MARK",
        "middle_name": "FRANCIS",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-09-12",
        "last_updated": "2023-12-13",
        "certification_date": "2023-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ND0101X",
            "taxonomy_group": "",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "GA",
            "license": "034773",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.