Individual provider Active NPI

Adam Joseph Pettigrew, M.D.

  • Infectious Disease Physician
  • Roswell, GA
National Provider Identifier
1902148539
Registry record updated Jul 6, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
License
79985 Issued in GA
Practice address
11660 Alpharetta Hwy Ste 430
Roswell, GA 30076
Phone
(770) 255-1069
NPI assigned
Mar 21, 2013
Last updated
Jul 6, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 6, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Infectious Disease Physician 207RI0200X 79985 GA Primary

Addresses

Primary practice location

11660 Alpharetta Hwy Ste 430
Roswell, GA 30076

Mailing address

11660 Alpharetta Hwy Ste 430
Roswell, GA 30076-3880

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
I20180803002571 GA Practitioner - Internal Medicine 2466700679 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Medical College of Georgia School of Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Infectious Disease Service of GeorgiaGroup PAC ID 3072564954, 10 clinicians

Practice addresses (Care Compare)

11660 Alpharetta Hwy
Suite 430
Roswell, GA 30076-3880
Phone (770) 255-1069

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
86.87 of 100Reported as group
Quality
72.75
Promoting interoperability
100
Improvement activities
40
Cost
66.81

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue210
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
79985GAMDInfectious Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Infectious Disease Services of Georgia PC Infectious Disease CurrentSince Jul 1, 2018 Accepting new patients
Infectious Disease Services of Ga PastSince Jul 1, 2018 Accepting new patients

Locations

11660 Alpharetta Hwy
Ste 430
Roswell, GA 30076
Phone (770) 255-1069

Interoperability endpoints

  • Direct secure messaging: drpettigrew@idsga.medentdirect.com

Organizations & group practices 2

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": "1363824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1530835200000",
    "number": "1902148539",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11660 ALPHARETTA HWY STE 430",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "300763880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11660 ALPHARETTA HWY STE 430",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "30076",
            "telephone_number": "770-255-1069"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETTIGREW",
        "first_name": "ADAM",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-03-21",
        "last_updated": "2018-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "GA",
            "license": "79985",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roswell, GA

Sources for this page

Verify at the official NPI Registry.