MR. TADEUSZ K WODECKI (MD) – Internal Medicine Physician, NPI 1619994472

MR. TADEUSZ K WODECKI (MD) is a healthcare provider. based in Stone mountain, Georgia. specializing in GENERAL PRACTICE. They hold the professional credentials MD. They hold a License No. 029264 (GA). The NPI Number for MR. TADEUSZ K WODECKI (MD) is 1619994472

Main info

Male
Sole Proprietor
47 Years Of Experience
Accepts Medicare Assignment
Name
MR. TADEUSZ K WODECKI (MD)
NPI
1619994472
Phone
(770) 413-1300
Address
2256 ROCKBRIDGE RD
Enumeration Date
17 July 2006
Last Update Date
17 January 2012

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7704131300
Graduation Year
1979 (47 years ago)
PAC ID
3779740014
Professional Enrollment ID
I20120130000287
Address ID
GA300873517ST2256XRDXX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience66
Completeness75
Years active:19State licenses:2Digital endpointsOther names

164 GENERAL PRACTICE in GA

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Provider Addresses for MR. TADEUSZ K WODECKI (MD)

  • Rockbridge Road, Stone Mountain, DeKalb County, Georgia, 30058, United States

    STONE MOUNTAIN, GA 30087

    Phone: (770) 413-1300

    Fax: (770) 413-0547

    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)

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: 2012-01-30

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
I20120130000287IGeneral PracticeGATBD

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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99213Established patient office or other outpatient visit, 20-29 minutes9943$0
99214Established patient office or other outpatient visit, 30-39 minutes4124$0
99215Established patient office or other outpatient visit, 40-54 minutes2112$0
View full utilization report →

Insurance plans in this area (ZIP 30087)

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Reviews

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Frequently asked questions

Where can patients find MR. TADEUSZ K WODECKI (MD)'s NPI?
You can confirm MR. TADEUSZ K WODECKI (MD) with NPI 1619994472; it appears in the national provider directory.
Is MR. TADEUSZ K WODECKI (MD)'s NPI currently valid?
The extract we use shows MR. TADEUSZ K WODECKI (MD) as active.
What field does MR. TADEUSZ K WODECKI (MD) work in?
You can think of MR. TADEUSZ K WODECKI (MD) as practicing within Internal Medicine Physician. Clinical services aligned with this taxonomy classification.
Where is MR. TADEUSZ K WODECKI (MD)'s primary listing?
We display Stone Mountain, Georgia because that is what the record indicates for MR. TADEUSZ K WODECKI (MD).
Is this NPI for an individual or an organization?
This listing corresponds to an Individual Provider.

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