MARY DIANE KINSELLA (M.D.) – Anatomic Pathology & Clinical Pathology Physician, NPI 1205010790
Anatomic Pathology & Clinical Pathology Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
391 PATHOLOGY in GA
Provider Addresses for MARY DIANE KINSELLA (M.D.)
1412 MILSTEAD AVE NE DEPT OF
CONYERS, GA 300123877
Phone: (678) 423-1550
Fax: (678) 423-1550
Type: Mailing
11 Upper Riverdale Rd SW
Southern Regional Hospital-Department of Pathology
Riverdale, GA 30274
Phone: (678) 423-1550
Fax: (678) 423-1550
Type: Location
5700 SOUTHWYCK BLVD
TOLEDO, OH 436141509
Phone: (800) 288-8325
Fax: (419) 866-5453
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
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Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2012-07-20
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20120720000025 | I | Pathology | GA | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 88305 | Pathology examination of tissue using a microscope, intermediate complexity | 995 | 417 | $0 |
| 88112 | Cell examination of specimen, selective cellular enhancement technique | 319 | 299 | $0 |
| 88312 | Special stained specimen slides to identify organisms including interpretation and report | 167 | 92 | $0 |
| 88313 | Special stained specimen slides to examine tissue including interpretation and report | 114 | 82 | $0 |
| G0416 | Surgical pathology, gross and microscopic examinations, for prostate needle biopsy, any method | 113 | 113 | $0 |
Insurance plans in this area (ZIP 30012)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| PATHOLOGY | GA | 88304 | Pathology examination of tissue using a microscope, moderately low complexity | 45 | 44 |
| PATHOLOGY | GA | 88307 | Pathology examination of tissue using a microscope, moderately high complexity | 21 | 19 |
| PATHOLOGY | GA | 88312 | Special stained specimen slides to identify organisms including interpretation and report | 526 | 304 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| P A T H O L O G Y | GA | |
| P A T H O L O G Y | GA | |
| P A T H O L O G Y | GA | |
| P A T H O L O G Y | GA | |
| P A T H O L O G Y | GA | |
| P A T H O L O G Y | GA | |
| P A T H O L O G Y | GA |
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