DR. CHARLES B JR. IDOM (M.D., FACS) – Urology Physician, NPI 1316943210
Urology Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
362 UROLOGY in GA
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Provider Addresses for DR. CHARLES B JR. IDOM (M.D., FACS)
1434, Broadrick Drive, Dalton, Whitfield County, Georgia, 30720, United States
DALTON, GA 307203009
Phone: (706) 278-5961
Fax: (706) 275-0280
Mailing address matches the actual address.
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 106 Open Payments records for all available years, with a total value of $3,008.
Total Amount is formed as General ($3,008) + Research ($0) + Ownership ($0) = $3,008.
Last reported payment date: 2024-12-19 • Largest payer in this snapshot: PROCEPT BioRobotics Corporation ($488).
Total Amount
$3,008
General + Research + Ownership
Payments
106
Total payment records
General Amount
$3,008
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-19
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| PROCEPT BioRobotics Corporation | $488 |
| PFIZER INC. | $292 |
| Teleflex LLC | $280 |
| Bayer Healthcare Pharmaceuticals Inc. | $207 |
| Sumitomo Pharma America, Inc. | $189 |
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: 2004-07-06
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 |
|---|---|---|---|---|
| I20040706000559 | I | Urology | 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 |
|---|---|---|---|---|
| Q9967 | Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml | 4,100 | 36 | $0 |
| 81000 | Manual urinalysis test with examination using microscope, non-automated | 1,317 | 600 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 696 | 455 | $0 |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 558 | 340 | $0 |
| 36415 | Insertion of needle into vein for collection of blood sample | 494 | 303 | $0 |
Insurance plans in this area (ZIP 30720)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| UROLOGY | GA | 55700 | Biopsy of prostate gland | 25 | 25 |
| UROLOGY | GA | 74177 | CT scan of abdomen and pelvis with contrast | 11 | 11 |
| UROLOGY | GA | 76942 | Ultrasonic guidance imaging supervision and interpretation for insertion of needle | 24 | 24 |
| UROLOGY | GA | 81002 | Urinalysis, manual test | 82 | 78 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| Physician Assistant | GA | |
| U R O L O G Y | FL | |
| P A T H O L O G Y | TN | |
| Nurse Practitioner | GA | |
| U R O L O G Y | GA |
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