NPIMap

Individual provider Active NPI

Ezequiel Leonardo Gleichgerrcht, M.D., PH.D.

  • Epilepsy Physician
  • Atlanta, GA
National Provider Identifier
1851779318
Registry record updated Jul 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Epilepsy PhysicianTaxonomy code 2084E0001X
License
94864 Issued in GA
Practice address
12 Executive Park Dr NE Ste 250
Atlanta, GA 30329-2206
Phone
(404) 778-3444
Fax
(404) 778-3444
NPI assigned
May 15, 2015
Last updated
Jul 25, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2024

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 38051 SC
Neurology Physician 2084N0400X 94864 GA
Clinical Neurophysiology Physician 2084N0600X 94864 GA
General Practice Physician 208D00000X 38051 SC
Epilepsy Physician 2084E0001X 94864 GA Primary

Addresses

Primary practice location

12 Executive Park Dr NE Ste 250
Atlanta, GA 30329-2206

Mailing address

12 Executive Park Dr NE Ste 250
Atlanta, GA 30329-2206
Phone (404) 778-3444

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC, GA2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20200226002197 SC Practitioner - Neurology 9436466406 Reassigns benefits to 1 organization
I20230621002195 GA Practitioner - Neurology 9436466406 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Emory Clinic IncGroup PAC ID 8820901408, 3,507 clinicians
Emory Medical Care Foundation IncGroup PAC ID 4981501814, 1,003 clinicians

Practice addresses (Care Compare)

1365 Clifton Rd NE
Atlanta, GA 30322-1013
Phone (404) 778-7525

80 Jesse Hill Jr Dr SE
Atlanta, GA 30303-3031
Phone (404) 616-1000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.24 of 100Reported as group
Quality
73.72
Promoting interoperability
100
Improvement activities
40
Cost
75.22

Merit-based Incentive Payment System (MIPS)

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

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
94864GAMDClinical Neurophysiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University Medical Associates of the Medical University of South Carol Current Accepting new patients
Emory Medical Care Foundation Inc CurrentSince Jul 1, 2023 Accepting new patients
Emory Medical Care Foundation Inc CurrentSince Jul 1, 2023 Accepting new patients
The Emory Clinic Inc CurrentSince Jul 1, 2023 Accepting new patients
University Medical Associates of the Medical University of South Carol Neurology CurrentSince Dec 11, 2019 Accepting new patients
Emory Health Care Neurology Past Accepting new patients
Emory University Past Accepting new patients

Locations

1365 Clifton Rd NE
Atlanta, GA 30322
Phone (404) 778-7525

2201 Henderson Mill Rd NE
Ste 160
Atlanta, GA 30345
Phone (404) 251-2193

80 Jesse Hill Jr Dr SE
Atlanta, GA 30303
Phone (404) 616-4370

171 Ashley Ave
Charleston, SC 29425
Phone (843) 792-2123

Organizations & group practices 7

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 6

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": "1431648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721865600000",
    "number": "1851779318",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 EXECUTIVE PARK DR NE STE 250",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303292206",
            "telephone_number": "404-778-3444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 EXECUTIVE PARK DR NE STE 250",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303292206",
            "telephone_number": "404-778-3444",
            "fax_number": "404-778-3444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLEICHGERRCHT",
        "first_name": "EZEQUIEL",
        "middle_name": "LEONARDO",
        "name_prefix": "Dr.",
        "credential": "M.D., PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-05-15",
        "last_updated": "2024-07-25",
        "certification_date": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "SC",
            "license": "38051",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "GA",
            "license": "94864",
            "primary": false
        },
        {
            "code": "2084N0600X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Clinical Neurophysiology",
            "state": "GA",
            "license": "94864",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "SC",
            "license": "38051",
            "primary": false
        },
        {
            "code": "2084E0001X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Epilepsy",
            "state": "GA",
            "license": "94864",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.