Individual provider Active NPI

Casey J Graybeal, MD

  • Surgery Physician
  • Gainesville, GA
National Provider Identifier
1841293453
Registry record updated Jan 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
043209 Issued in GA
Practice address
1075 Jesse Jewell Pkwy NE
Ste B
Gainesville, GA 30501-3814
Phone
(770) 536-5733
Fax
(770) 534-2114
NPI assigned
May 27, 2005
Last updated
Jan 26, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 26, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 043209 GA Primary

Addresses

Primary practice location

1075 Jesse Jewell Pkwy NE
Ste B
Gainesville, GA 30501-3814

Mailing address

PO Box 742616
Atlanta, GA 30374-2616
Phone (770) 219-8420

Other identifiers 1

IdentifierTypeStateIssuer
00751176AMedicaidGA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address cgraybeal29373@nghs.gadirect.net Direct

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
I20100127000487 GA Practitioner - General Surgery 2264414416 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Emory University School of Medicine, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1075 Jesse Jewell Pkwy NE
Suite B
Gainesville, GA 30501-3814
Phone (770) 219-9200

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
87.83 of 100Reported as group
Quality
80.36
Promoting interoperability
100
Improvement activities
40
Cost
79.08

Procedures performed for Medicare patients

ProcedureNumber of procedures
Upper gastrointestinal (GI) endoscopy for acid reflux267

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
043209GAMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Northeast Georgia Surgical Associates PC Surgery CurrentSince Jan 1, 2010 Accepting new patients
Northeast Georgia Physicians Group Inc Surgery CurrentSince Jan 1, 2010 Accepting new patients
Northeast Georgia Medical Center, Inc. Past Accepting new patients

Locations

1404 River Pl
Ste 303
Braselton, GA 30517
Phone (770) 848-3319

1075 Jesse Jewell Pkwy NE
Ste B
Gainesville, GA 30501
Phone (770) 219-9200

597 S Enota Dr NE
Gainesville, GA 30501
Phone (770) 219-8275

Interoperability endpoints

  • Direct secure messaging: cgraybeal29373@nghs.gadirect.net

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.

Hospital & facility affiliations 1

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": "1117152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611619200000",
    "number": "1841293453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 742616",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303742616",
            "telephone_number": "770-219-8420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1075 JESSE JEWELL PKWY NE",
            "address_2": "STE B",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305013814",
            "telephone_number": "770-536-5733",
            "fax_number": "770-534-2114"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAYBEAL",
        "first_name": "CASEY",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-05-27",
        "last_updated": "2021-01-26",
        "certification_date": "2021-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "GA",
            "license": "043209",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00751176A",
            "state": "GA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cgraybeal29373@nghs.gadirect.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1075 Jesse Jewell Pkwy NE",
            "address_2": "Ste B",
            "city": "Gainesville",
            "state": "GA",
            "country_code": "US",
            "postal_code": "305013814",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Gainesville, GA

Sources for this page

Verify at the official NPI Registry.