THE EMORY CLINIC INC – Internal Medicine Physician, NPI 1396798229
Internal Medicine Physician
Main info
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for THE EMORY CLINIC INC
Clifton Road Northeast, Emory Highlands, Druid Hills, DeKalb County, Georgia, 30329, United States
ATLANTA, GA 303221013
Phone: (404) 778-2144
Fax: (404) 778-3002
Type: Location
Emory Clinic Corporate Office, 101, West Ponce de Leon Avenue, Decatur, DeKalb County, Georgia, 30030, United States
DECATUR PLAZA ANNEX
DECATUR, GA 300302542
Phone: (404) 778-2144
Fax: (404) 778-3002
Type: Mailing
2201 HENDERSON MILL RD NE STE 160
ATLANTA, GA 303452711
Phone: (404) 778-2144
Fax: (404) 778-3002
Type: Mailing
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: 2025-09-26
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Past revalidation due date
Earliest CMS due date was 2024-05-31 (737 days ago).
Enrollment records
4
Earliest due date
2024-05-31
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 |
|---|---|---|---|---|
| O20031110000503 | O | Clinic/Group Practice | GA | TBD |
| O20091216000424 | O | End-Stage Renal Disease Facility (Esrd) | GA | TBD |
| O20100930068690 | O | Multi-Specialty - Physician | GA | 2024-05-31 |
| O20250926003026 | O | Clinic/Group Practice | KY | TBD |
What to do next
- Verify current status on the CMS Revalidation Lookup Tool immediately.
- Complete revalidation in PECOS or contact your Medicare Administrative Contractor (MAC).
- Overdue revalidation can lead to deactivation of Medicare billing privileges.
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 30322)
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