MARVIN MANSUKHBHAI VAISHNANI M.D.
NPI 1184069510
Internal Medicine in Newnan, GA

Q: What is Marvin Vaishnani's NPI number?

The NPI number for Marvin Vaishnani is 1184069510. It was assigned to this individual provider in the NPPES registry on April 29, 2013.

Q: What is Marvin Vaishnani's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Q: When was this NPI record last updated?

The NPPES record for Marvin Vaishnani was last updated on April 15, 2024. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since April 29, 2013PECOS EnrolledAccepts Medicare Assignment

46.12/100

CMS Quality Rating

745 POPLAR RD, NEWNAN, GA 30265(770) 400-2353 Get Directions Write a Review

NPPES record last updated: April 15, 2024. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Apr 15, 2024, Sep 15, 2016 (2 updates tracked since 2016).

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About Marvin Mansukhbhai Vaishnani M.d. NPPES

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

MARVIN MANSUKHBHAI VAISHNANI M.D. (NPI 1184069510) is an individual internal medicine provider in Newnan, Georgia, licensed in Georgia (75939) and active in the NPI registry since April 2013. He is enrolled in Medicare PECOS, is affiliated with Piedmont Newnan Hospital, Inc, and maintains a secondary practice location in Rome.

NPPES Registry Identity

NPI1184069510

Entity TypeIndividualMale

Primary Taxonomy207R00000X

Provider Legal NameMARVIN MANSUKHBHAI VAISHNANICredential: M.D.

Location Address745 POPLAR RDNewnan, GA 30265-1618

Mailing Address501 Redmond Rd NwRome, GA 30165-1415 · (706) 291-0291

Phone(770) 400-2353

Sole ProprietorYes

Medical School CMSOtherGraduated 2010

Enumeration DateApril 29, 2013

Last NPPES UpdateApril 15, 20242 updates tracked since enumeration

NPPES CertifiedApril 15, 2024

✔ NPI 1184069510 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207R00000X

License✔ Licensed in GA · 75939

Definition

A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

Also ListedHospitalistTaxonomy 208M00000X · License 75939 (GA)

745 POPLAR RD, Newnan, GA 30265

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Secondary Practice Location 1

Location 1501 Redmond Rd NWRome, GA 30165-1415 · Phone (706) 291-0291

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Alliant Health Plans, Inc..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

Marvin Mansukhbhai Vaishnani 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 ID42512972

PECOS Enrollment IDI20161019002374

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 5

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.

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes 99233

Follow-up hospital inpatient care per day typically involves a 35-minute check-up by your healthcare provider. This service includes monitoring your health progress, adjusting your treatment plan if needed, and answering any questions you may have about your condition or care.

300 services147 patients

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232

Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.

218 services117 patients

Hospital discharge day management, more than 30 minutes 99239

Hospital discharge day management over 30 minutes involves a detailed process to ensure a smooth transition from hospital to home. It includes final examinations, discussion of your hospital stay, post-discharge instructions, and coordinating follow-up care.

130 services130 patients

Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes 99223

Initial hospital inpatient care per day, typically 70 minutes, refers to the daily medical service provided to patients admitted to the hospital. This includes a comprehensive evaluation, diagnosis, treatment plan, and monitoring of your health condition. It ensures your well-being during your hospital stay.

54 services53 patients

Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes 99222

Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.

11 services11 patients

Hospital Affiliations CMS Care Compare

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

Piedmont Newnan Hospital, Inc

Acute Care Hospitals · Newnan, GA

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number110229

Location745 Poplar RoadNewnan, GA 30265 · Coweta County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 30265 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

$124.10 typical visit price

range $53.31 – $164.04

Typical copayment $31.02 (range $13.32 – $41.01)

Most-billed visit code 99204

Established Patient

$94.84 typical visit price

range $16.68 – $133.24

Typical copayment $23.71 (range $4.17 – $33.31)

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.

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.

46.12/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Individually scored

Quality

26.41

Improvement Activities

Reported Quality Measures

Advance Care Plan

100%423 patients5/55-star benchmark: 100%

Documentation of Current Medications in the Medical Record

100%234 patients5/55-star benchmark: 100%

Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

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.

Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing E0431

DME-Oxygen and Supplies · category DC000N

2 suppliers25 claims25 services$21.06 avg. paid by Medicare

Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390

DME-Oxygen and Supplies · category DC002N

2 suppliers25 claims25 services$117.31 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

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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.

MARCUS STEPHEN WILBANKS

Registered Nurse