DR. THADDEUS IVORY LANCASTER (MD) – Obstetrics & Gynecology Physician, NPI 1316904923

DR. THADDEUS IVORY LANCASTER (MD) is a healthcare provider. based in Atlanta, Georgia. specializing in OBSTETRICS/GYNECOLOGY. They hold the professional credentials MD. They hold a License No. 073192 (MD). The NPI Number for DR. THADDEUS IVORY LANCASTER (MD) is 1316904923

Main info

Male
24 Years Of Experience
Accepts Medicare Assignment
Name
DR. THADDEUS IVORY LANCASTER (MD)
NPI
1316904923
Phone
(470) 325-0100
Address
PO BOX 116156
Enumeration Date
27 April 2006
Last Update Date
18 January 2022

Doctor Profile

Medical School Name
MEHARRY MEDICAL COLLEGE SCHOOL OF MEDICINE
Secondary Phone
4043647206
Graduation Year
2002 (24 years ago)
PAC ID
3577641414
Group Practice PAC ID
6204829013
Professional Enrollment ID
I20150701002242
Address ID
GA303051729AT3495XNEXX400

Contacts

SOAP Endpoint
https://careepiceast.kp.org:14430/Interconnect-prodgam/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience54
Completeness85
Years active:20State licenses:1Other namesUpdated within 12 months

1,266 OBSTETRICS/GYNECOLOGY in GA

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Provider Addresses for DR. THADDEUS IVORY LANCASTER (MD)

  • PO BOX 116156

    ATLANTA, GA 303686156

    Phone: (470) 325-0100

    Fax: (470) 325-0193

    Type: Mailing

  • Pleasant Hill Road, Duluth, Gwinnett County, Georgia, 30096, United States

    DULUTH, GA 300968030

    Phone: (678) 312-7800

    Fax: (678) 312-7818

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

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: 2015-07-01

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

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20150701002242IObstetrics/GynecologyGATBD

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.

Verify on CMS Revalidation Lookup Tool

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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 30368)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 6204829013View full group profile

Reviews

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Frequently asked questions

What unique ID ties claims to DR. THADDEUS IVORY LANCASTER (MD)?
NPI 1316904923 is assigned to DR. THADDEUS IVORY LANCASTER (MD) under the national enumeration system.
Is DR. THADDEUS IVORY LANCASTER (MD) currently active in the NPI registry?
CMS-published data lists DR. THADDEUS IVORY LANCASTER (MD) as an active registrant.
Can you summarize DR. THADDEUS IVORY LANCASTER (MD)'s specialty in plain language?
Clinically, the directory lists DR. THADDEUS IVORY LANCASTER (MD) with Obstetrics & Gynecology Physician. Clinical services aligned with this taxonomy classification.
Does DR. THADDEUS IVORY LANCASTER (MD) practice in Georgia?
You will see Atlanta, Georgia on file for DR. THADDEUS IVORY LANCASTER (MD) alongside any extra practice locations.
Is DR. THADDEUS IVORY LANCASTER (MD) a real provider?
This page reflects official NPPES data for NPI 1316904923. Always confirm identity and privileges with the practice and licensing boards.

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