AJAY PREMKUMAR MD, MPH
NPI 1194188458
Orthopaedic Surgery - Adult Reconstructive Orthopaedic Surgery in Atlanta, GA

Q: What is Ajay Premkumar's NPI number?

The NPI number for Ajay Premkumar is 1194188458. It was assigned to this individual provider in the NPPES registry on April 3, 2016.

Q: What is Ajay Premkumar's specialty?

The primary specialty registered for this NPI is Orthopaedic Surgery, specializing in Adult Reconstructive Orthopaedic Surgery, with taxonomy code 207XS0114X.

Q: When was this NPI record last updated?

The NPPES record for Ajay Premkumar was last updated on August 9, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.

Active since April 03, 2016PECOS Enrolled

92.26/100

CMS Quality Rating

21 ORTHO LN, ATLANTA, GA 30329(678) 336-6928 Get Directions Write a Review

NPPES record last updated: August 9, 2022. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Aug 9, 2022, Apr 30, 2022, Apr 27, 2021 and 1 more (4 updates tracked since 2016).

On this page

About Ajay Premkumar Md, Mph NPPES

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

AJAY PREMKUMAR MD, MPH (NPI 1194188458) is an individual adult reconstructive orthopaedic surgery provider in Atlanta, Georgia, licensed in Georgia (91707) and active in the NPI registry since April 2016. He is enrolled in Medicare PECOS, is affiliated with Emory University Hospital, and is a graduate of Emory University School Of Medicine (2016).

NPPES Registry Identity

NPI1194188458

Entity TypeIndividualMale

Primary Taxonomy207XS0114X

Provider Legal NameAJAY PREMKUMARCredential: MD, MPH

Location Address21 ORTHO LNAtlanta, GA 30329-2315

Mailing Address21 Ortho LnAtlanta, GA 30329-2315

Phone(678) 336-6928

Sole ProprietorNo

Medical School CMSEmory University School Of MedicineGraduated 2016

Enumeration DateApril 3, 2016

Last NPPES UpdateAugust 9, 20224 updates tracked since enumeration

NPPES CertifiedAugust 9, 2022

✔ NPI 1194188458 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOrthopaedic Surgery · Adult Reconstructive Orthopaedic SurgeryAllopathic & Osteopathic Physicians

Taxonomy Code207XS0114X

License✔ Licensed in GA · 91707

Definition

Recognized by several state medical boards as a fellowship subspecialty program of orthopaedic surgery, adult reconstructive orthopaedic surgeons deal with reconstructive procedures such as joint arthroplasty (i.e., hip and knee), osteotomy, arthroscopy, soft-tissue reconstruction, and a variety of other adult reconstructive surgical procedures.

21 ORTHO LN, Atlanta, GA 30329

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter Health, Oscar Health.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Ajay Premkumar Md, Mph is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID5395083505

PECOS Enrollment IDI20220818003838

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.

Medicare Billing Reassignment

Medicare enrollment records show Ajay Premkumar reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

The Emory Clinic Inc

2.4 mi

Internal Medicine

1365 CLIFTON RD NE
Atlanta, GA 30322

Reassigned Medicare billing, Georgia enrollment
4,840 clinicians in this Medicare group

NPI 1396798229 (404) 778-2144

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 12

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.

182 services150 patients

Computer-assisted surgery for muscle and bone procedure 20985

Computer-assisted surgery for muscle and bone procedures involves using a computer to aid in planning and performing surgery. This technology helps increase precision, reduce invasiveness, and improve outcomes. It's commonly used in orthopedic surgeries like joint replacements.

124 services118 patients

Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215

This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.

80 services72 patients

Replacement of knee joint, both sides of knee 27447

A bilateral knee joint replacement is a procedure where the damaged parts of both your knee joints are replaced with artificial parts. It aims to relieve pain and improve mobility. The process involves a surgical operation under anesthesia.

62 services60 patients

New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204

This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.

60 services60 patients

X-ray of knee, 4 or more views 73564

An X-ray of the knee, 4 or more views, is a non-invasive imaging test. It involves capturing multiple images of your knee from different angles. This helps in diagnosing conditions such as fractures, arthritis, or infections. The procedure is quick and painless.

48 services47 patients

Replacement of thigh bone and hip joint with prosthesis 27130

This procedure, known as hip arthroplasty, involves replacing your damaged thigh bone and hip joint with artificial parts, called a prosthesis. It helps relieve pain, improve mobility, and enhance your quality of life.

42 services41 patients

Therapy procedure using a special bandage and vacuum pump, surface area 50.0 sq cm or less 97605

This procedure, known as Negative Pressure Wound Therapy, involves a special bandage and vacuum pump. The bandage covers your wound and the pump creates a vacuum, enhancing healing by removing excess fluid and promoting tissue growth. The surface area treated is 50.0 sq cm or less.

25 services24 patients

X-ray of hip, minimum of 4 views 73503

An X-ray of the hip with a minimum of 4 views is a non-invasive procedure that uses a small amount of radiation to produce images of the hip joint from different angles. This helps to diagnose conditions such as fractures, arthritis, or other abnormalities. It's a quick, painless process.

21 services21 patients

X-ray of knee, 1-2 views 73560

An X-ray of the knee with 1-2 views is a quick, painless test that produces images of the knee bones. It helps identify fractures, infections, or changes in the knee joint. During the procedure, you'll be asked to stay still while the X-ray machine captures the images.

19 services18 patients

Replacement of knee joint on side of knee 27446

A knee joint replacement on one side, also known as unicompartmental knee replacement, is a surgical procedure where damaged parts of the knee joint are replaced with artificial parts. This helps to reduce pain and improve mobility. It's typically done under general anesthesia.

16 services14 patients

X-ray of hip, 2-3 views 73502

An X-ray of the hip with 2-3 views is a non-invasive imaging test. It uses a small amount of radiation to produce pictures of the hip joint. These images help in diagnosing conditions like fractures, arthritis, or other abnormalities. The process is quick and painless.

15 services14 patients

Hospital Affiliations CMS Care Compare 2

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

Emory University Hospital

Acute Care Hospitals · Atlanta, GA

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number110010

Location1364 Clifton Road, NEAtlanta, GA 30322 · De Kalb County

Emergency services

Emory University Hospital Midtown

Acute Care Hospitals · Atlanta, GA

2/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number110078

Location550 Peachtree Street, NEAtlanta, GA 30308 · Fulton 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.

92.26/100

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

Scored through an Alternative Payment Model

Quality

73.83

Promoting Interoperability

100

Improvement Activities

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.

DR. JASPER TSENG MD

Physical Medicine & Rehabilitation

21 ORTHO LN
ATLANTA, GA 30329

Dekalb County (404) 778-7000

DR. RANDY S KATZ DO

Preventive Medicine (Occupational Medicine)

21 ORTHO LN
ATLANTA, GA 30329

Dekalb County (404) 778-7000

VICTORIA PAIGE MANIACI PA-C

Physician Assistant

21 ORTHO LN
ATLANTA, GA 30329

Dekalb County (404) 778-3350

DR. MORGAN MICHELLE HEINZELMANN-WEISBAUM MD

Psychiatry & Neurology (Pain Medicine)

21 ORTHO LN
ATLANTA, GA 30329

Dekalb County (047) 783-3504

ELIZABETH A. SOFIA P.A.

Physician Assistant

21 ORTHO LN
ATLANTA, GA 30329

Dekalb County (404) 778-3350

ROBERT JOSEPH MALDONADO MD

Physical Medicine & Rehabilitation

21 ORTHO LN
ATLANTA, GA 30329

Dekalb County (678) 841-3032

OMAR SYED MD

Student in an Organized Health Care Education/Training Program

21 ORTHO LN
ATLANTA, GA 30329

Dekalb County (631) 913-5139

HILLARY CATHERINE O'KELLEY

Nurse Practitioner (Acute Care)

21 ORTHO LN
ATLANTA, GA 30329

Dekalb County (404) 778-3350

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 Ajay Premkumar's NPI number?

The NPI number for Ajay Premkumar is 1194188458. It was assigned to this individual provider in the NPPES registry on April 3, 2016.

Where is Ajay Premkumar located?

Ajay Premkumar practices at 21 Ortho Ln, Atlanta, GA 30329. The listed phone number is (678) 336-6928.

What is Ajay Premkumar's specialty?

The primary specialty registered for this NPI is Orthopaedic Surgery, specializing in Adult Reconstructive Orthopaedic Surgery, with taxonomy code 207XS0114X.

Is Ajay Premkumar enrolled in Medicare?

Yes. Ajay Premkumar is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Ajay Premkumar's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Ajay Premkumar reassigns Medicare benefits to The Emory Clinic Inc (Atlanta, GA). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Ajay Premkumar's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Ajay Premkumar accept?

Health plans from Ambetter Health and Oscar Health list Ajay Premkumar 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 Ajay Premkumar affiliated with any hospitals?

According to CMS data, Ajay Premkumar is affiliated with Emory University Hospital and Emory University Hospital Midtown.

When was this NPI record last updated?

The NPPES record for Ajay Premkumar was last updated on August 9, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.