NPIMap

Individual provider Active NPI

Jason L Konzelmann, MD

  • Emergency Medicine Physician
  • Gainesville, GA
National Provider Identifier
1891845590
Registry record updated Jan 30, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
59990 Issued in GA
Practice address
743 Spring St NE
Gainesville, GA 30501-3899
Phone
(678) 357-9327
NPI assigned
Jan 12, 2007
Last updated
Jan 30, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 59990 GA Primary

Addresses

Primary practice location

743 Spring St NE
Gainesville, GA 30501-3899

Mailing address

P.O. Box 6002
Urbana, IL 61803-6002
Phone (217) 326-8300

Other identifiers 1

IdentifierTypeStateIssuer
202I935064OtherGAMEDICARE OF GA

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
I20080523000458 GA Practitioner - Emergency Medicine 0941395461 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Southern Illinois University School of Medicine, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Georgia Observation and Telehealth Services, LLCGroup PAC ID 1951888262, 21 clinicians
Georgia Emergency Department Services, P.C.Group PAC ID 5597751032, 76 clinicians

Practice addresses (Care Compare)

1400 River PL
Braselton, GA 30517-5600
Phone (770) 848-8000

743 Spring Nest
Gainesville, GA 30501-3715
Phone (770) 503-3000

743 Spring St NE
Gainesville, GA 30501-3715
Phone (770) 219-9000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
92.02 of 100Reported as group
Quality
91.38
Improvement activities
40
Cost
79.01

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
59990GAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Union County Hospital Authority CurrentSince Dec 10, 2016 Accepting new patients
Georgia Emergency Department Services, P.C. Emergency Medicine CurrentSince Jul 1, 2015 Accepting new patients
Union County Hospital Authority CurrentSince Dec 10, 2016 Accepting new patients
Georgia Observation and Telehealth Services, LLC CurrentSince Jan 3, 2026 Accepting new patients
Wendy L Smith M.D. PC Past Accepting new patients
Darling Emergency Physicians LLC Emergency Medicine Past Accepting new patients
Solantic LLC Past Accepting new patients

Locations

35 Hospital Rd
Blairsville, GA 30512
Phone (706) 439-6812

1400 River Pl
Braselton, GA 30517
Phone (770) 219-6000

743 Spring St NE
Gainesville, GA 30501
Phone (770) 219-5915

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 2

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": "1168560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548806400000",
    "number": "1891845590",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 6002",
            "city": "URBANA",
            "state": "IL",
            "postal_code": "618036002",
            "telephone_number": "217-326-8300",
            "fax_number": "217-326-2856"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "743 SPRING ST NE",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305013899",
            "telephone_number": "678-357-9327"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KONZELMANN",
        "first_name": "JASON",
        "middle_name": "L",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-12",
        "last_updated": "2019-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "GA",
            "license": "59990",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE OF GA",
            "identifier": "202I935064",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gainesville, GA

Sources for this page

Verify at the official NPI Registry.