ANDREW R CLEMENTZ (MD) – Family Medicine Physician, NPI 1689171621

ANDREW R CLEMENTZ (MD) is a healthcare provider. based in Atlanta, Georgia. specializing in FAMILY PRACTICE. They hold the professional credentials MD. They hold a License No. 83828 (GA). The NPI Number for ANDREW R CLEMENTZ (MD) is 1689171621

Main info

Male
8 Years Of Experience
Accepts Medicare Assignment
Name
ANDREW R CLEMENTZ (MD)
NPI
1689171621
Phone
(404) 778-6920
Address
4500 N SHALLOWFORD RD STE B
Enumeration Date
6 April 2018
Last Update Date
30 September 2022

Doctor Profile

Medical School Name
OTHER
Secondary Phone
5614964000
Graduation Year
2018 (8 years ago)
PAC ID
5193074920
Group Practice PAC ID
4789861584
Professional Enrollment ID
I20230718000298
Address ID
FL334453901DE4205XAVEX403
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience45
Completeness75
Years active:8State licenses:1Digital endpointsOther names

3,103 FAMILY PRACTICE in GA

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Provider Addresses for ANDREW R CLEMENTZ (MD)

  • 4500 N SHALLOWFORD RD STE B

    ATLANTA, GA 303386476

    Phone: (404) 778-6920

    Fax: (404) 778-6901

    Type: Mailing

  • 4500, North Shallowford Road, Huntley Hills, Dunwoody, DeKalb County, Georgia, 30338, United States

    DUNWOODY, GA 30338

    Phone: (404) 778-6920

    Fax: (404) 778-6901

    Type: Location

  • 1220 CAROLINE ST NE STE A-230

    ATLANTA, GA 303072749

    Phone: (678) 710-3980

    Fax: (404) 778-6901

    Type: Mailing

  • 1863 MEMORIAL DR SE

    ATLANTA, GA 303172103

    Phone: (470) 717-0719

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 26 Open Payments records for all available years, with a total value of $768.

Total Amount is formed as General ($768) + Research ($0) + Ownership ($0) = $768.

Last reported payment date: 2024-11-14 • Largest payer in this snapshot: Lilly USA, LLC ($275).

Total Amount

$768

General + Research + Ownership

Payments

26

Total payment records

General Amount

$768

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-11-14

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

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: 2023-07-18

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking 2 Medicare enrollment records; no due dates published yet.

Enrollment records

2

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
I20200206002993IFamily PracticeGATBD
I20230718000298IFamily PracticeFLTBD

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
99214Established patient office or other outpatient visit, 30-39 minutes205170$0
99213Established patient office or other outpatient visit, 20-29 minutes9378$0
36415Insertion of needle into vein for collection of blood sample4541$0
99215Established patient office or other outpatient visit, 40-54 minutes2323$0
93000Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report1616$0
View full utilization report →

Insurance plans in this area (ZIP 30338)

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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: 4789861584View full group profile
NameSpecialtyState
Family PracticeFL

Reviews

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Frequently asked questions

Does ANDREW R CLEMENTZ (MD) have a public NPI I can cite?
Public records show ANDREW R CLEMENTZ (MD) under NPI 1689171621.
Quick check: is ANDREW R CLEMENTZ (MD) active?
Public NPPES data shows ANDREW R CLEMENTZ (MD) with an active NPI status right now.
What services align with ANDREW R CLEMENTZ (MD)'s listing?
ANDREW R CLEMENTZ (MD)'s public classification highlights Family Medicine Physician. Clinical services aligned with this taxonomy classification.
Is ANDREW R CLEMENTZ (MD) tied to Atlanta, Georgia?
If you are local to Atlanta, Georgia, ANDREW R CLEMENTZ (MD) may be relevant to your search.
What is the difference between NPI and a medical license?
An NPI is a federal identifier; a medical license is issued by a state and governs where someone may practice.

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