NPIMap

Individual provider Active NPI

Matthew Carmichael, M.D.

  • Otolaryngology Physician
  • Lawrenceville, GA
National Provider Identifier
1871820852
Registry record updated Jul 3, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
79617 Issued in GA
Practice address
766 Walther Rd Ste 300
Lawrenceville, GA 30046
Phone
(770) 237-3000
NPI assigned
Nov 11, 2009
Last updated
Jul 3, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 3, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X 79617 GA Primary

Addresses

Primary practice location

766 Walther Rd Ste 300
Lawrenceville, GA 30046

Mailing address

766 Walther Rd Ste 300
Lawrenceville, GA 30046-8765
Phone (770) 237-3000

Other practice location 1

4385 Johns Creek Pkwy Ste 250
Suwanee, GA 30024-6095
Phone (770) 623-1608

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180806002017 GA Practitioner - OtolaryngologyPractitioner - Allergy/ImmunologyPractitioner - Diagnostic Radiology 9234487398 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
OtolaryngologyAlso: Allergy/Immunology, Diagnostic Radiology
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northeast Atlanta Ear Nose and Throat, P.C.Group PAC ID 7012979636, 15 clinicians

Practice addresses (Care Compare)

766 Walther Rd
Suite 300
Lawrenceville, GA 30046-8765
Phone (770) 237-3000

Hospital & facility affiliations

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

Practice roles

OrganizationSpecialtyStatusNew patients
Northeast Atlanta Ear Nose & Throat, PC Otolaryngology CurrentSince Jul 1, 2018 Accepting new patients
Northlake Anesthesia Professionals, LLC CurrentSince Sep 1, 2020 Accepting new patients
Northside Primary Care Professional Services, LLC Past Accepting new patients

Locations

766 Walther Rd
Ste 300
Lawrenceville, GA 30046
Phone (770) 237-3000

4385 Johns Creek Pkwy
Ste 250
Suwanee, GA 30024
Phone (770) 237-3000

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 5

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": "1257897600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1530576000000",
    "number": "1871820852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "766 WALTHER RD STE 300",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300468765",
            "telephone_number": "770-237-3000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "766 WALTHER RD STE 300",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "30046",
            "telephone_number": "770-237-3000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4385 Johns Creek Pkwy Ste 250",
            "address_purpose": "LOCATION",
            "city": "Suwanee",
            "state": "GA",
            "postal_code": "300246095",
            "country_code": "US",
            "telephone_number": "770-623-1608",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CARMICHAEL",
        "first_name": "MATTHEW",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-11-11",
        "last_updated": "2018-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "GA",
            "license": "79617",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lawrenceville, GA

Sources for this page

Verify at the official NPI Registry.