Caleb Eric Ackermann, MD

Individual provider Active NPI Surgical Critical Care Physician · Lawrenceville, GA

NPI 1972130102 · NPPES record last updated Aug 30, 2026

Key facts

NPI
1972130102
Entity type
Individual (NPI type 1)
Primary specialty
Surgical Critical Care Physician 2086S0102X
License
114657 (GA)
Practice address
631 Professional Dr Ste 360
Lawrenceville, GA 30046-3370
Phone
(678) 312-2733
NPI assigned
Mar 26, 2020
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Enrolled (2 enrollments) in NV, VA
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20200810003450 NV Order and Referring Only - General Surgery
Practitioner - General Surgery
5799100525
I20250809000015 VA Order and Referring Only - General Surgery
Practitioner - General Surgery
5799100525

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Medicine

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Critical Care Physician 2086S0102X 114657 GA Yes

Addresses

Primary practice location

631 Professional Dr Ste 360
Lawrenceville, GA 30046-3370

Mailing address

631 Professional Dr Ste 360
Lawrenceville, GA 30046-3370
Phone (678) 312-2733

Other providers in Lawrenceville, GA

All providers in Lawrenceville, GA · Surgical Critical Care Physician in Georgia

Sources for this page

Verify at the official NPI Registry.