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MS. VALENCIA R BURRUSS M.D.
NPI 1215972823
Family Medicine in Douglasville, GA

Active since June 18, 2006PECOS EnrolledAccepts Medicare Assignment
6126 PRESTLEY MILL RD STE H, DOUGLASVILLE, GA 30134(678) 715-2993(678) 715-2827 Get Directions Write a Review

NPPES record last updated: September 13, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Sep 13, 2024, Jun 25, 2024 (2 updates tracked since 2024).

About Ms. Valencia R Burruss M.d. NPPES

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

MS. VALENCIA R BURRUSS M.D. (NPI 1215972823) is an individual family medicine provider in Douglasville, Georgia, licensed in Georgia (041745) and active in the NPI registry since June 2006. She is enrolled in Medicare PECOS, is affiliated with Wellstar Douglas Medical Center, and is a graduate of University Of Alabama School Of Medicine (1993).

NPPES Registry Identity

NPI1215972823
Entity TypeIndividualFemale
Primary Taxonomy207Q00000X
Provider Legal NameMS. VALENCIA R BURRUSSCredential: M.D.
Location Address6126 PRESTLEY MILL RD STE HDouglasville, GA 30134-5624
Mailing Address3529 Olde River RdDouglasville, GA 30135-5105
Phone(678) 715-2993
Fax(678) 715-2827
Sole ProprietorYes
Medical School CMSUniversity Of Alabama School Of MedicineGraduated 1993
Enumeration DateJune 18, 2006
Last NPPES UpdateSeptember 13, 20242 updates tracked since enumeration
NPPES CertifiedSeptember 13, 2024
✔ NPI 1215972823 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in GA · 041745
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.
6126 PRESTLEY MILL RD STE H, Douglasville, GA 30134
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Other Identifiers 2

Other010606457GA · Tricare
Medicaid000752386DGA

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

Ms. Valencia R Burruss 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 ID1355639659
PECOS Enrollment IDI20180829000979
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 7

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.

Chronic care management services, first 20 minutes of clinical staff time directed by health care professional, per calendar month 99490
Chronic care management services involve a healthcare professional directing clinical staff in managing your chronic conditions. This includes the first 20 minutes per month of services like medication management, care coordination, and health monitoring to help improve your health and quality of life.
218 services35 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
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.
204 services75 patients
Management using the results of remote vital sign monitoring per calendar month, first 20 minutes 99457
This service involves reviewing and managing your health data, which is remotely monitored and collected. Your vital signs like heart rate and blood pressure are tracked regularly throughout the month. The first 20 minutes of this data analysis per month is included in this service.
183 services30 patients
Remote monitoring of physiologic parameters, initial supply of devices with daily recordings or programmed alerts transmission, each 30 days 99454
This service involves using devices to remotely track body functions like heart rate or blood pressure. These devices, provided initially, record data daily or send alerts if readings are abnormal. The service is renewed every 30 days.
182 services30 patients
Insertion of needle into vein for collection of blood sample 36415
This procedure involves inserting a small needle into a vein, typically in your arm, to collect a blood sample. It's a quick and simple process to help diagnose or monitor health conditions. You may feel a small prick, but discomfort is minimal.
47 services39 patients
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.
40 services35 patients

Hospital Affiliations CMS Care Compare

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

Wellstar Douglas Medical Center

Acute Care Hospitals · Douglasville, GA
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number110184
Location8954 Hospital DriveDouglasville, GA 30134 · Douglas County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 30134 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.

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.

Reported Quality Measures

Breast Cancer Screening
Percentage of women 50-74 years of age who had a mammogram to screen for breast cancer
46%334 patients3/55-star benchmark: 92%
Colorectal Cancer Screening
Percentage of adults 50-75 years of age who had appropriate screening for colorectal cancer
36%543 patients2/55-star benchmark: 85%
Diabetes: Eye Exam
Percentage of patients 18-75 years of age with diabetes who had a retinal or dilated eye exam by an eye care professional during the measurement period or a negative retinal exam (no evidence of retinopathy) in the 12 months prior to the measurement period
20%217 patients1/55-star benchmark: 100%
Preventive Care and Screening: Influenza Immunization
Percentage of patients aged 6 months and older seen for a visit between October 1 and March 31 who received an influenza immunization OR who reported previous receipt of an influenza immunization
1%1,075 patients1/55-star benchmark: 88%
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

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

Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service K0553
DME-Other DME · category DE017N
1 supplier12 claims12 services$206.23 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

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

PHOENIXLABORATORY SERVICES LLC
Physiological Laboratory
6126 PRESTLEY MILL RD STE H
DOUGLASVILLE, GA 30134
Douglas County (678) 715-2993

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 Valencia Burruss's NPI number?

The NPI number for Valencia Burruss is 1215972823. It was assigned to this individual provider in the NPPES registry on June 18, 2006.

Where is Valencia Burruss located?

Valencia Burruss practices at 6126 Prestley Mill Rd Ste H, Douglasville, GA 30134. The listed phone number is (678) 715-2993.

What is Valencia Burruss's specialty?

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

Is Valencia Burruss enrolled in Medicare?

Yes. Valencia Burruss 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 Valencia Burruss accept?

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

According to CMS data, Valencia Burruss is affiliated with Wellstar Douglas Medical Center.

When was this NPI record last updated?

The NPPES record for Valencia Burruss was last updated on September 13, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 22 months 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.