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MARIAM NEMATALLA ANTONIOS D.O.
NPI 1164885901
Family Medicine in Lawrenceville, GA

Active since March 30, 2016PECOS EnrolledAccepts Medicare Assignment
665 DULUTH HWY STE 501, LAWRENCEVILLE, GA 30046(678) 312-0400 Get Directions Write a Review

NPPES record last updated: September 22, 2020. Verified against the NPPES registry weekly; last sync: October 04, 2026.

Record update history: Sep 22, 2020, Sep 3, 2020, Jun 9, 2020 and 1 more (4 updates tracked since 2016).

About Mariam Nematalla Antonios D.o. NPPES

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

MARIAM NEMATALLA ANTONIOS D.O. (NPI 1164885901) is an individual family medicine provider in Lawrenceville, Georgia, licensed in Georgia (86461) and active in the NPI registry since March 2016. She is enrolled in Medicare PECOS, is affiliated with Grady Memorial Hospital, and maintains a secondary practice location in Baltimore.

NPPES Registry Identity

NPI1164885901
Entity TypeIndividualFemale
Primary Taxonomy207Q00000X
Provider Legal NameMARIAM NEMATALLA ANTONIOSCredential: D.O.
Location Address665 DULUTH HWY STE 501Lawrenceville, GA 30046-8709
Mailing Address665 Duluth Hwy Ste 501Lawrenceville, GA 30046-8709 · (678) 312-0400
Phone(678) 312-0400
Sole ProprietorNo
Medical School CMSRowan University School Of Osteopathic MedicineGraduated 2016
Enumeration DateMarch 30, 2016
Last NPPES UpdateSeptember 22, 20204 updates tracked since enumeration
NPPES CertifiedSeptember 22, 2020
✔ NPI 1164885901 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Licenses✔ Licensed in GA · 86461✔ Licensed in GA · 00000
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
665 DULUTH HWY STE 501, Lawrenceville, GA 30046
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Other Names 1

Former Name (1)Mariam Nematalla D.o.

Secondary Practice Location 1

Location 19000 Franklin Square DrBaltimore, MD 21237-3901 · Phone (443) 777-8257 · Fax (443) 777-7053

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Absolute Total Care, Ambetter Health, Ambetter of Alabama and more.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

Mariam Nematalla Antonios D.o. 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 ID1254751274
PECOS Enrollment IDI20201013002562
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.

Areas of Expertise CMS Part B claims

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
30 services25 patients

Hospital Affiliations CMS Care Compare

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

Grady Memorial Hospital

Acute Care Hospitals · Atlanta, GA
1/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number110079
Location80 Jesse Hill, Jr Drive SEAtlanta, GA 30303 · Fulton County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 30046 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$88.06 typical visit price
range $56.84 – $172.43
Typical copayment $22.01 (range $14.21 – $43.10)
Most-billed visit code 99203
Established Patient
$100.20 typical visit price
range $18.22 – $140.40
Typical copayment $25.05 (range $4.55 – $35.10)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 16

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

TIK PAU M.D.
Family Medicine
665 DULUTH HWY STE 501
LAWRENCEVILLE, GA 30046
Gwinnett County (678) 312-0400
SHAHIL PATEL DO
Student in an Organized Health Care Education/Training Program
665 DULUTH HWY STE 501
LAWRENCEVILLE, GA 30046
Gwinnett County (678) 341-0400
JULIA ROTH DO
Student in an Organized Health Care Education/Training Program
665 DULUTH HWY STE 501
LAWRENCEVILLE, GA 30046
Gwinnett County (678) 312-0400
MUHAMMAD KAMRAN SIDDIQ DO
Student in an Organized Health Care Education/Training Program
665 DULUTH HWY STE 501
LAWRENCEVILLE, GA 30046
Gwinnett County (678) 312-0400
DR. LEWAA SHOUJAA MD
Student in an Organized Health Care Education/Training Program
665 DULUTH HWY STE 501
LAWRENCEVILLE, GA 30046
Gwinnett County (678) 312-0400
ALY SALEH DO
Student in an Organized Health Care Education/Training Program
665 DULUTH HWY STE 501
LAWRENCEVILLE, GA 30046
Gwinnett County (678) 312-0400
FERUZA MUSTAFAYEVNA BEZGUNOVA
Student in an Organized Health Care Education/Training Program
665 DULUTH HWY STE 501
LAWRENCEVILLE, GA 30046
Gwinnett County (678) 312-0491
MR. RANDY YOUNG KIM
Student in an Organized Health Care Education/Training Program
665 DULUTH HWY STE 501
LAWRENCEVILLE, GA 30046
Gwinnett County (678) 312-0400

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 Mariam Antonios's NPI number?

The NPI number for Mariam Antonios is 1164885901. It was assigned to this individual provider in the NPPES registry on March 30, 2016. The provider is also known as Mariam Nematalla D.O..

Where is Mariam Antonios located?

Mariam Antonios practices at 665 Duluth Hwy Ste 501, Lawrenceville, GA 30046. The listed phone number is (678) 312-0400.

What is Mariam Antonios's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Mariam Antonios enrolled in Medicare?

Yes. Mariam Antonios 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 Mariam Antonios accept?

Health plans from Ambetter Health, Ambetter from Absolute Total Care, Ambetter of Alabama, Ambetter of North Carolina and Ambetter of Tennessee list Mariam Antonios 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 Mariam Antonios affiliated with any hospitals?

According to CMS data, Mariam Antonios is affiliated with Grady Memorial Hospital.

When was this NPI record last updated?

The NPPES record for Mariam Antonios was last updated on September 22, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.