SHOMARI ANDRE RUFFIN M.D.
NPI 1114185840
Orthopaedic Surgery - Sports Medicine in Carrollton, GA

Active since May 29, 2008PECOS EnrolledAccepts Medicare Assignment
76.59/100
CMS Quality Rating
150 CLINIC AVE, SUITE 101, CARROLLTON, GA 30117(770) 834-0873(770) 834-6118 Get Directions Write a Review

NPPES record last updated: October 30, 2014. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Shomari Andre Ruffin M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SHOMARI ANDRE RUFFIN M.D. (NPI 1114185840) is an individual sports medicine provider in Carrollton, Georgia, licensed in Georgia (72107) and active in the NPI registry since May 2008. He is enrolled in Medicare PECOS, is affiliated with Northside Hospital Gwinnett, and is a graduate of Medical College Of Georgia School Of Medicine (2008).

NPPES Registry Identity

NPI1114185840
Entity TypeIndividualMale
Primary Taxonomy207XX0005X
Provider Legal NameSHOMARI ANDRE RUFFINCredential: M.D.
Location Address150 CLINIC AVE, SUITE 101Carrollton, GA 30117-4401
Mailing Address150 Clinic Ave, Suite 101Carrollton, GA 30117-4401 · (770) 834-0873 · Fax (770) 834-6118
Fax(770) 834-6118
Sole ProprietorYes
Medical School CMSMedical College Of Georgia School Of MedicineGraduated 2008
Enumeration DateMay 29, 2008
Last NPPES UpdateOctober 30, 2014
NPI 1114185840 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyOrthopaedic Surgery · Sports MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207XX0005X
License Licensed in GA · 72107
Definition

An orthopaedic surgeon trained in sports medicine provides appropriate care for all structures of the musculoskeletal system directly affected by participation in sporting activity. This specialist is proficient in areas including conditioning, training and fitness, athletic performance and the impact of dietary supplements, pharmaceuticals, and nutrition on performance and health, coordination of care within the team setting utilizing other health care professionals, field evaluation and management, soft tissue biomechanics and injury healing and repair. Knowledge and understanding of the principles and techniques of rehabilitation, athletic equipment and orthotic devices enables the specialist to prevent and manage athletic injuries.

150 CLINIC AVE, Carrollton, GA 30117

Other Identifiers 1

MedicaidREF000630555GA

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Shomari Andre Ruffin M.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID648413922
PECOS Enrollment IDI20140729000721
Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Hospital Affiliations CMS Care Compare 2

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Northside Hospital Gwinnett

Acute Care Hospitals · Lawrenceville, GA
2/5 CMS rating
OwnershipGovernment - Hospital District or Authority
CMS Certification Number110087
Location1000 Medical Center BoulevardLawrenceville, GA 30046 · Gwinnett County
Birthing friendly

Piedmont Eastside Medical Center

Acute Care Hospitals · Snellville, GA
2/5 CMS rating
OwnershipProprietary
CMS Certification Number110192
Location1700 Medical WaySnellville, GA 30078 · Gwinnett County
Emergency services Birthing friendly

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

76.59/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality72.46
Improvement Activities40

Referred Medical Equipment & Supplies CMS DME claims 2

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Wrist hand orthosis, wrist extension control cock-up, non molded, prefabricated, off-the-shelf L3908
DME-Orthotic Devices · category DF000N
1 supplier11 claims13 services$45.65 avg. paid by Medicare
Walking boot, pneumatic and/or vacuum, with or without joints, with or without interface material, prefabricated, off-the-shelf L4361
DME-Orthotic Devices · category DF003N
1 supplier20 claims20 services$228.81 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Nurse Practitioner (Family)
150 CLINIC AVE, SUITE 202
CARROLLTON, GA 30117
Urology
150 CLINIC AVE, SUITE 202
CARROLLTON, GA 30117
Audiologist
150 CLINIC AVE, SUITE 201
CARROLLTON, GA 30117
Nurse Practitioner
150 CLINIC AVE, SUITE 101
CARROLLTON, GA 30117
Audiologist
150 CLINIC AVE, SUITE 201
CARROLLTON, GA 30117
Audiologist
150 CLINIC AVE, SUITE 201
CARROLLTON, GA 30117
Physician Assistant
150 CLINIC AVE, SUITE 101
CARROLLTON, GA 30117
Urology
150 CLINIC AVE, SUITE 202
CARROLLTON, GA 30117

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Shomari Ruffin's NPI number?

The NPI number for Shomari Ruffin is 1114185840. It was assigned to this individual provider in the NPPES registry on May 29, 2008.

Where is Shomari Ruffin located?

Shomari Ruffin practices at 150 Clinic Ave Suite 101, Carrollton, GA 30117. The listed phone number is (770) 834-0873.

What is Shomari Ruffin's specialty?

The primary specialty registered for this NPI is Orthopaedic Surgery, specializing in Sports Medicine, with taxonomy code 207XX0005X.

Is Shomari Ruffin enrolled in Medicare?

Yes. Shomari Ruffin is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Shomari Ruffin accept?

Health plans from Alliant Health Plans, Inc. list Shomari Ruffin as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Shomari Ruffin affiliated with any hospitals?

According to CMS data, Shomari Ruffin is affiliated with Northside Hospital Gwinnett and Piedmont Eastside Medical Center.

When was this NPI record last updated?

The NPPES record for Shomari Ruffin was last updated on October 30, 2014. NPI Profile syncs with the weekly NPPES data releases published by CMS.