NPIMap

Organization Active NPI

Metro Surgical, PC

  • Surgery Physician
  • Rincon, GA
National Provider Identifier
1902823024
Registry record updated Feb 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
Legal business name
METRO SURGICAL, PC
Practice address
594 S Columbia Ave
Suite 100
Rincon, GA 31326-9092
Phone
(912) 826-4057
Fax
(912) 826-2853
NPI assigned
Jul 16, 2006
Last updated
Feb 4, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2022

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

Authorized official

Name
Sue Payne
Title
Office Manager
Phone
(912) 826-4057

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X NU Primary
Colon & Rectal Surgery Physician 208C00000X NU

Addresses

Primary practice location

594 S Columbia Ave
Suite 100
Rincon, GA 31326-9092

Mailing address

PO Box 919
Rincon, GA 31326-0919
Phone (912) 826-4057

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040503000742 GA Part B Supplier - Clinic/Group Practice 2961490669 Receives reassigned benefits from 21 practitioners
Practice locations: Rincon, GA; Sylvania, GA; Savannah, GA; Richmond Hill, GA; Jesup, GA; Baxley, GA; Pooler, GA

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Metro Surgical2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

209 Mims Rd
#C
Sylvania, GA 30467

Interoperability endpoints

  • Direct secure messaging: anthonyfoley@metrosurgi.allscriptsdirect.net
  • Direct secure messaging: joeychristmas@metrosurgi.allscriptsdirect.net
  • Direct secure messaging: johnodom@metrosurgi.allscriptsdirect.net
  • Direct secure messaging: markblankenship@metrosurgi.allscriptsdirect.net
  • Direct secure messaging: oscarmoreno-ponte@metrosurgi.allscriptsdirect.net
  • Direct secure messaging: paulhinchey@metrosurgi.allscriptsdirect.net
  • Direct secure messaging: ravindrageorge@metrosurgi.allscriptsdirect.net

Practitioners & affiliated clinicians

Practitioners 24

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 24

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1153008000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1643932800000",
    "number": "1902823024",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 919",
            "city": "RINCON",
            "state": "GA",
            "postal_code": "313260919",
            "telephone_number": "912-826-4057",
            "fax_number": "912-826-2853"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "594 S COLUMBIA AVE",
            "address_2": "SUITE 100",
            "city": "RINCON",
            "state": "GA",
            "postal_code": "313269092",
            "telephone_number": "912-826-4057",
            "fax_number": "912-826-2853"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "METRO SURGICAL, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-16",
        "last_updated": "2022-02-04",
        "certification_date": "2022-02-04",
        "status": "A",
        "authorized_official_last_name": "PAYNE",
        "authorized_official_first_name": "SUE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "912-826-4057"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "208C00000X",
            "taxonomy_group": "",
            "desc": "Colon & Rectal Surgery",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rincon, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.