Michael Ian Quackenbush, D.O.

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

License

072421 Issued in GA

Practice address

1285 Hembree Rd
Suite 200a
Roswell, GA 30076-5720

Phone

(770) 475-2710

Fax

(770) 360-0498

NPI assigned

Jun 15, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 2

Electronic endpoints 1

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

Specialty

Orthopedic Surgery

Education

Arizona College of Osteopathic Medicine Mid Western University, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Wellstar Medical Group LLCGroup PAC ID 6709065402, 3,059 clinicians

Select Rehabilitation, LLCGroup PAC ID 9032020490, 1,935 clinicians

Physiotherapy Associates IncGroup PAC ID 3577470442, shared by 50 NPIs, 1,432 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Wellstar Home Health, LLC Home health agency, Marietta, GA, CCN 117102
• Accentcare Home Health of Georgia Home health agency, Roswell, GA, CCN 117131
• Visiting Nurse Health System, Inc Home health agency, Marietta, GA, CCN 117000
• Central HH Care, an Amedisys Company Home health agency, Atlanta, GA, CCN 117039
• Wellstar North Fulton Medical Center Hospital, Roswell, GA, CCN 110198
• Northside Hospital Forsyth Hospital, Cumming, GA, CCN 110005
• Wellstar Windy Hill Hospital Long-term care hospital, Marietta, GA, CCN 112007

Merit-based Incentive Payment System (MIPS)

Final score

93.93 of 100Reported as apm

Quality

82.14

Promoting interoperability

100

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mquackenbush148136@directwellstar.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Wellstar Medical Group, LLC

  • Family Medicine Physician
  • Kennesaw, GA
  • NPI 1558664003
  Medicare reassignment Care Compare group NPD
• Select Rehabilitation, LLC

  • Rehabilitation Clinic/Center
  • Glenview, IL
  • NPI 1346368248
  Care Compare group
• Wellstar Medical Group, LLC

  • Multi-Specialty Clinic/Center
  • Marietta, GA
  • NPI 1275992240
  NPD
• Lima Memorial Joint Operating Company

  • General Acute Care Hospital
  • Lima, OH
  • NPI 1336144732
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Amedisys Georgia LLC

  • Home Health Agency
  • Atlanta, GA
  • NPI 1831147529
  Care Compare affiliation
• Guardian Home Care, LLC

  • Home Health Agency
  • Roswell, GA
  • NPI 1992736227
  Care Compare affiliation
• Kennestone Hospital, Inc.

  • Long Term Care Hospital
  • Marietta, GA
  • NPI 1700853041

  Long-term care hospital

  Care Compare affiliation
• Northside Hospital, Inc.

  • General Acute Care Hospital
  • Cumming, GA
  • NPI 1376574277
  Care Compare affiliation
• Visiting Nurse Health System, Inc

  • Home Health Agency
  • Marietta, GA
  • NPI 1992766273
  Care Compare affiliation
• Wellstar Home Health, LLC

  • Home Health Agency
  • Marietta, GA
  • NPI 1073591376
  Care Compare affiliation
• Wellstar North Fulton Hospital, Inc

  • General Acute Care Hospital
  • Roswell, GA
  • NPI 1750312997
  Care Compare affiliation

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

{
    "created_epoch": "1181865600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635292800000",
    "number": "1962607424",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4500 HOSPITAL BLVD STE 230",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "300760001",
            "telephone_number": "770-956-4560",
            "fax_number": "770-475-8968"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1285 HEMBREE RD",
            "address_2": "SUITE 200A",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "300765720",
            "telephone_number": "770-475-2710",
            "fax_number": "770-360-0498"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4500 Hospital Blvd Ste 230",
            "address_purpose": "LOCATION",
            "city": "Roswell",
            "state": "GA",
            "postal_code": "300760001",
            "country_code": "US",
            "telephone_number": "770-956-4560",
            "fax_number": "770-475-8968",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "QUACKENBUSH",
        "first_name": "MICHAEL",
        "middle_name": "IAN",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-15",
        "last_updated": "2021-10-27",
        "certification_date": "2021-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XX0801X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Orthopaedic Trauma",
            "state": "OH",
            "license": "34009678",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "GA",
            "license": "072421",
            "primary": true
        },
        {
            "code": "207XX0801X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Orthopaedic Trauma",
            "state": "NJ",
            "license": "25MB08109900",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003149994A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2987237",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mquackenbush148136@directwellstar.org",
            "affiliation": "N",
            "address_1": "4500 Hospital Blvd Ste 230",
            "city": "Roswell",
            "state": "GA",
            "country_code": "US",
            "postal_code": "300760001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Orthopaedic Surgery Physician in Roswell, GA
• Providers in Roswell, GA by specialty
• Orthopaedic Surgery Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.