KRISTIN GREGORY PA
NPI 1003925967
Physician Assistant in Cumming, GA

NPI Status: Active since August 30, 2006

Contact Information

1505 NORTHSIDE BLVD
SUITE 1500
CUMMING, GA
ZIP 30041
Phone: (770) 781-5077
Fax: (770) 781-3915

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  • Individual
  • Female
  • Years of Experience 22
  • Physician Assistant
  • Accepts Insurance
  • Accepts Medicare Approved Payment
  • PECOS Enrolled
  • Medicare Quality Reporting

About KRISTIN GREGORY

This page provides the complete NPI Profile along with additional information for Kristin Gregory, a primary care provider established in Cumming, Georgia with a medical specialization in Physician Assistant and more than 22 years of experience. The healthcare provider is registered in the NPI registry with number 1003925967 assigned on August 2006. The practitioner's primary taxonomy code is 363A00000X with license number 5715 (GA). The provider is registered as an individual and her NPI record was last updated 11 years ago.

NPI
1003925967
Provider Name
KRISTIN GREGORY PA
Gender
Female
Entity Type
Individual
Location Address
1505 NORTHSIDE BLVD SUITE 1500 CUMMING, GA 30041
Location Phone
(770) 781-5077
Location Fax
(770) 781-3915
Mailing Address
1505 NORTHSIDE BLVD SUITE 1500 CUMMING, GA 30041
Mailing Phone
(770) 781-5077
Mailing Fax
(770) 781-3915
Medical School Name
OTHER
Graduation Year
2004
Is Sole Proprietor?
No
Enumeration Date
08-30-2006
Last Update Date
09-22-2015
Code Navigator

A primary care provider (PCP) like Kristin Gregory sees people with common medical problems. The primary care provider might be a doctor, physician assistant, nurse practitioner or clinic that are usually involved in your long-term care. A PCP might provide preventive care, treat common medical conditions, identify urgent medical problems and refer you to specialists when necessary. Primary care is usually provided in an outpatient facility but if you are admitted to a hospital your PCP may assist in your care. The most common medical conditions seen by primary care providers are: hypertension, upper respiratory tract infections, depression or anxiety, back pain, arthritis, dermatitis, diabetes, urinary tract infections, etc

Location Map

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Physician Assistant

Taxonomy Code
363A00000X
Type
Physician Assistants & Advanced Practice Nursing Providers
License No.
5715
License State
GA
Taxonomy Description
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

Secondary Taxonomies

The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.

No. Taxonomy Code Type Classification /
Specialization
License No. (State)
1363A00000XPhysician Assistants & Advanced Practice Nursing Providers

Physician Assistant

PA9103077 (FL)

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

  • Elite Bronze - HMO
  • Elite Bronze + Vision + Adult Dental - HMO
  • Everyday Bronze - HMO
  • Everyday Bronze + Vision + Adult Dental - HMO
  • Focused Silver - HMO
  • Standard Expanded Bronze - HMO
  • Standard Gold - HMO
  • Standard Silver - HMO
  • Standard Silver + Vision + Adult Dental - HMO
  • Clarity Silver - HMO
  • Complete Gold - HMO
  • Complete Gold + Vision + Adult Dental - HMO
  • Elite Bronze - HMO
  • Elite Bronze + Vision + Adult Dental - HMO
  • Enhanced Diabetes Care Silver with $0 Drug Options - HMO
  • Enhanced Diabetes Care Silver with $0 Drug Options + Vision + Adult Dental - HMO
  • Everyday Bronze - HMO
  • Everyday Bronze + Vision + Adult Dental - HMO
  • Everyday Gold - HMO
  • Complete Gold - EPO
  • Complete Gold + Vision + Adult Dental - EPO
  • Elite Bronze - EPO
  • Elite Bronze + Vision + Adult Dental - EPO
  • Elite Gold - EPO
  • Elite Gold + Vision + Adult Dental - EPO
  • Enhanced Diabetes Care Silver with $0 Drug Options - EPO
  • Enhanced Diabetes Care Silver with $0 Drug Options + Vision + Adult Dental - EPO
  • Everyday Bronze - EPO
  • Everyday Bronze + Vision + Adult Dental - EPO
  • Clear Silver with $0 Insulin Options - HMO
  • Complete Gold - HMO
  • Complete Gold + Vision + Adult Dental - HMO
  • Complete Gold with Atrium Health - HMO
  • Complete Gold with Atrium Health + Vision + Adult Dental - HMO
  • Elite Bronze - HMO
  • Elite Bronze + Vision + Adult Dental - HMO
  • Elite Bronze with Atrium Health - HMO
  • Elite Bronze with Atrium Health + Vision + Adult Dental - HMO
  • Enhanced Asthma/COPD Care Silver with $0 Drug Options - HMO
  • Elite Bronze - EPO
  • Elite Bronze + Vision + Adult Dental - EPO
  • Elite Gold - EPO
  • Elite Gold + Vision + Adult Dental - EPO
  • Enhanced Diabetes Care Silver with $0 Drug Options - EPO
  • Enhanced Diabetes Care Silver with $0 Drug Options + Vision + Adult Dental - EPO
  • Everyday Bronze - EPO
  • Everyday Bronze + Vision + Adult Dental - EPO
  • Everyday Gold - EPO
  • Everyday Gold + Vision + Adult Dental - EPO

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
Q64424MEDICARE UPIN (02)FL 
U6993ZMEDICARE ID-TYPE UNSPECIFIED (04)FL 

Medicare Participation & PECOS Enrollment Status

Kristin Gregory is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.

Kristin Gregory is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.

  • Is the provider registered in PECOS? Yes

  • PECOS PAC ID: 8224044474

    What is the PECOS Associate Control ID?
    A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.

  • PECOS Enrollment ID: I20130906000545

    What is the Provider Enrollment ID?
    The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.

  • Accepts Medicare Assignment? Yes

    What does it mean "accepts medicare assignment"?
    When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
    A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.

  • Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes

  • Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes

  • Eligible to Order or Refer a Home Health Agency (HHA): Yes

  • Eligible to Order or Refer Power Mobility Devices: Yes

Areas of Expertise

The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.

Biopsy of related skin growth, each additional growth

A biopsy of related skin growth is a procedure where a small piece of skin growth is removed for testing. If additional growths are identified, they may also be biopsied. This helps in diagnosing skin conditions and planning appropriate treatment.

This service was performed 12 times for 11 patients

Biopsy of related skin growth, first growth

A biopsy of a skin growth involves taking a small sample of the growth to examine it under a microscope. This helps determine if the growth is harmful. The procedure is typically quick, with minimal discomfort. It's a crucial step in ensuring your skin's health.

This service was performed 49 times for 49 patients

Destruction of precancer skin growth, 1 growth

"Destruction of precancer skin growth" is a procedure that eliminates a single precancerous skin growth. This is done to prevent it from developing into skin cancer. The growth may be removed using various methods such as cryotherapy (freezing), laser therapy, or topical medications.

This service was performed 45 times for 44 patients

Destruction of precancer skin growth, 2-14 growths

This procedure involves removing 2-14 precancerous skin growths. The growths are treated to prevent them from potentially developing into skin cancer. The process is safe, with minimal discomfort, and promotes healthier skin.

This service was performed 72 times for 19 patients

Established patient office or other outpatient visit, 20-29 minutes

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

This service was performed 119 times for 117 patients

New patient office or other outpatient visit, 30-44 minutes

This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.

This service was performed 18 times for 18 patients

Physician Visit Costs



The typical physician office visit costs for Medicare beneficiaries in this area are: $22.01 for a new patient copayment and $17.71 for an established patient copayment.

The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.

For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.

The prices below reflect the costs for new and established patients in the 30041 ZIP code area.

New Patients Visit Costs *

The most utilized procedure code for new patients office visits is 99203

  • Average New Patient Price $88.06
  • Minimum New Patient Price $56.84
  • Maximum New Patient Price $172.43
  • Average New Patient Copayment $22.01
  • Minimum New Patient Copayment $14.21
  • Maximum New Patient Copayment $43.1

Established Patients Visit Costs *

The most utilized procedure code for established patients office visits is 99213

  • Average Established Patient Price $70.85
  • Minimum Established Patient Price $18.22
  • Maximum Established Patient Price $140.4
  • Average Established Patient Copayment $17.71
  • Minimum Established Patient Copayment $4.55
  • Maximum Established Patient Copayment $35.1

* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.

Quality Reporting

The provider participated in CMS Quality Payment Program. The Quality Payment Program aims to improve population health, reduce costs and improve the care received by Medicare beneficiaries. The following quality measures meet Medicare's statistical reporting standards. Not all providers report the same information, because not all providers give the same services to patients. The quality information is just a snapshot of some the care providers give to their patients. Reporting more or less information is not a reflection of quality.

Quality Measure Performance Number of Patients
Care transition standard operational improvementsYesN/A
Establish standard operations to manage transitions of care that could include one or more of the following: Establish formalized lines of communication with local settings in which empaneled patients receive care to ensure documented flow of information and seamless transitions in care; and/or Partner with community or hospital-based transitional care services.
Documentation of Current Medications in the Medical Record 100% 97
Percentage of visits for patients aged 18 years and older for which the eligible professional or eligible clinician attests to documenting a list of current medications using all immediate resources available on the date of the encounter. This list must include ALL known prescriptions, over-the-counters, herbals, and vitamin/mineral/dietary (nutritional) supplements AND must contain the medications' name, dosage, frequency and route of administration
e-Prescribing 97% 6197
At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.
Health Information Exchange 11% 179
The MIPS eligible clinician that transitions or refers their patient to another setting of care or health care clinician (1) uses CEHRT to create a summary of care record; and (2) electronically transmits such summary to a receiving health care clinician for at least one transition of care or referral.
Implementation of Use of Specialist Reports Back to Referring Clinician or Group to Close Referral LoopYesN/A
Performance of regular practices that include providing specialist reports back to the referring individual MIPS eligible clinician or group to close the referral loop or where the referring individual MIPS eligible clinician or group initiates regular inquiries to specialist for specialist reports which could be documented or noted in the EHR technology.
Medication Reconciliation 99% 5329
The MIPS eligible clinician performs medication reconciliation for at least one transition of care in which the patient is transitioned into the care of the MIPS eligible clinician.
Patient-Specific Education 98% 4321
The MIPS eligible clinician must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide access to those materials to at least one unique patient seen by the MIPS eligible clinician.
Pneumococcal Vaccination Status for Older Adults 82% 38
Percentage of patients 65 years of age and older who have ever received a pneumococcal vaccine
Practice Improvements for Bilateral Exchange of Patient InformationYesN/A
Ensure that there is bilateral exchange of necessary patient information to guide patient care, such as Open Notes, that could include one or more of the following: • Participate in a Health Information Exchange if available; and/or • Use structured referral notes.
Provide Patient Access 84% 4321
At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician's discretion to withhold certain information.
Secure Messaging 8% 4321
For at least one unique patient seen by the MIPS eligible clinician during the performance period, a secure message was sent using the electronic messaging function of CEHRT to the patient (or the patient-authorized representative), or in response to a secure message sent by the patient (or the patient-authorized representative) during the performance period.
Security Risk AnalysisYesN/A
Conduct or review a security risk analysis in accordance with the requirements in 45 CFR 164.308(a)(1), including addressing the security (to include encryption) of ePHI data created or maintained by certified EHR technology in accordance with requirements in 45 CFR164.312(a)(2)(iv) and 45 CFR 164.306(d)(3), and implement security updates as necessary and correct identified security deficiencies as part of the MIPS eligible clinician's risk management process.
Specialized Registry ReportingYesN/A
The MIPS eligible clinician is in active engagement to submit data to specialized registry. To earn a 5 % bonus in the promoting interoperability performance category score for submitting to one or more public health or clinical data registries also attest to PI_TRANS_PHCDRR_3_MULTI.
Use of QCDR for feedback reports that incorporate population healthYesN/A
Use of a QCDR to generate regular feedback reports that summarize local practice patterns and treatment outcomes, including for vulnerable populations.

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1003925967, we treat the final digit (7) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 53. The final step is to find the difference between that total and the next multiple of ten (60 - 53 = 7).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
0
Unchanged
Pos 3
0
Doubled → 0
Pos 4
3
Unchanged
Pos 5
9
Doubled → 18 → 1 + 8
Pos 6
2
Unchanged
Pos 7
5
Doubled → 10 → 1 + 0
Pos 8
9
Unchanged
Pos 9
6
Doubled → 12 → 1 + 2
Check
7
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 0 → 0 9 → 18 → 9 5 → 10 → 1 6 → 12 → 3

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 0 + 0 + 3 + 1 + 8 + 2 + 1 + 0 + 9 + 1 + 2 + 24 = 53

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 53 is 60. The difference is the calculated check digit.

60 - 53 = 7
This NPI is valid
The calculated check digit is 7, which matches the last digit of 1003925967.

Other Providers at the Same Location


The following 20 providers are registered at the same or a nearby location.

Obstetrics & Gynecology (Obstetrics)
1505 NORTHSIDE BLVD, SUITE 3500
CUMMING, GA 30041
Internal Medicine (Hematology & Oncology)
1505 NORTHSIDE BLVD, SUITE 4300
CUMMING, GA 30041
Internal Medicine (Gastroenterology)
1505 NORTHSIDE BLVD, SUITE 4700
CUMMING, GA 30041
Advanced Practice Midwife
1505 NORTHSIDE BLVD, SUITE 3500
CUMMING, GA 30041
Internal Medicine (Endocrinology, Diabetes & Metabolism)
1505 NORTHSIDE BLVD, SUITE 2800
CUMMING, GA 30041
Internal Medicine (Pulmonary Disease)
1505 NORTHSIDE BLVD, SUITE 3000
CUMMING, GA 30041
Internal Medicine (Gastroenterology)
1505 NORTHSIDE BLVD
CUMMING, GA 30041
Ophthalmology
1505 NORTHSIDE BLVD, SUITE 1200
CUMMING, GA 30041
Pharmacy (Community/Retail Pharmacy)
1505 NORTHSIDE BLVD, STE 1600
CUMMING, GA 30041
Dietitian, Registered
1505 NORTHSIDE BLVD, SUITE 2800
CUMMING, GA 30041
Obstetrics & Gynecology
1505 NORTHSIDE BLVD, SUITE 3500
CUMMING, GA 30041
Durable Medical Equipment & Medical Supplies
1505 NORTHSIDE BLVD, SUITE 4300
CUMMING, GA 30041
Obstetrics & Gynecology
1505 NORTHSIDE BLVD, SUITE 2400
CUMMING, GA 30041
Ophthalmology
1505 NORTHSIDE BLVD, SUITE 1200
CUMMING, GA 30041
Durable Medical Equipment & Medical Supplies
1505 NORTHSIDE BLVD, SUITE 4600
CUMMING, GA 30041
Registered Nurse
1505 NORTHSIDE BLVD, 2500
CUMMING, GA 30041
Nurse Practitioner (Adult Health)
1505 NORTHSIDE BLVD, STE 2800
CUMMING, GA 30041
Orthopaedic Surgery
1505 NORTHSIDE BLVD, SUITE 3100
CUMMING, GA 30041
Dermatology
1505 NORTHSIDE BLVD, SUITE 1500
CUMMING, GA 30041
Nurse Practitioner
1505 NORTHSIDE BLVD, SUITE 4600
CUMMING, GA 30041

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1003925967, enumerated as an "individual" on August 30, 2006.

The provider is located at 1505 NORTHSIDE BLVD SUITE 1500 CUMMING, GA 30041 and the phone number is (770) 781-5077.

Physician Assistant with taxonomy code 363A00000X.

The provider might be accepting Accepts: Ambetter from Absolute Total Care, Ambetter. Please consult your insurance carrier or call the provider to verify.