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DONALD J CAMPBELL MD
NPI 1225185028
Plastic Surgery in Gainesville, GA

Active since January 04, 2007PECOS EnrolledAccepts Medicare Assignment
82.55/100
CMS Quality Rating
1296 SIMS ST., SUITE B, GAINESVILLE, GA 30501(770) 534-1856(770) 531-0355 Get Directions Write a Review

NPPES record last updated: July 21, 2020. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Donald J Campbell Md NPPES

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

DONALD J CAMPBELL MD (NPI 1225185028) is an individual plastic surgery provider in Gainesville, Georgia, licensed in Georgia (059049) and active in the NPI registry since January 2007. He is enrolled in Medicare PECOS, is affiliated with Northeast Georgia Medical Center, Inc, and is a graduate of Mercer University School Of Medicine (1999).

NPPES Registry Identity

NPI1225185028
Entity TypeIndividualMale
Primary Taxonomy208200000X
Provider Legal NameDONALD J CAMPBELLCredential: MD
Location Address1296 SIMS ST., SUITE BGainesville, GA 30501-0001
Mailing AddressPo Box 742616Atlanta, GA 30374-2616 · (770) 219-8420
Phone(770) 534-1856
Fax(770) 531-0355
Sole ProprietorNo
Medical School CMSMercer University School Of MedicineGraduated 1999
Enumeration DateJanuary 4, 2007
Last NPPES UpdateJuly 21, 2020
NPPES CertifiedJuly 21, 2020
✔ NPI 1225185028 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPlastic SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code208200000X
License✔ Licensed in GA · 059049
Definition

A plastic surgeon deals with the repair, reconstruction or replacement of physical defects of form or function involving the skin, musculoskeletal system, craniomaxillofacial structures, hand, extremities, breast and trunk and external genitalia or cosmetic enhancement of these areas of the body. Cosmetic surgery is an essential component of plastic surgery. The plastic surgeon uses cosmetic surgical principles to both improve overall appearance and to optimize the outcome of reconstructive procedures. The surgeon uses aesthetic surgical principles not only to improve undesirable qualities of normal structures but in all reconstructive procedures as well.

1296 SIMS ST., Gainesville, GA 30501
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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

Donald J Campbell Md 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 ID3971601089
PECOS Enrollment IDI20070612000791
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 4

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.

New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203
This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.
19 services19 patients
Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more 99212
This is a routine check-up for patients who have previously seen the doctor. During this 10-19 minute visit, the doctor will review your health status, discuss any concerns, and manage ongoing treatments or medications. It's a chance to ensure your health is on track.
18 services13 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.
15 services11 patients
Initial hospital care with straightforward or low level of medical decision making, per day, if using time, at least 40 minutes 99221
Initial hospital inpatient care refers to the first day of your stay in the hospital. This service typically includes a 30-minute check-up with a healthcare professional. They'll assess your health, discuss your condition, and plan your treatment. It's part of ensuring you receive the best possible care.
15 services14 patients

Hospital Affiliations CMS Care Compare

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

Northeast Georgia Medical Center, Inc

Acute Care Hospitals · Gainesville, GA
3/5 CMS rating
OwnershipGovernment - Local
CMS Certification Number110029
Location743 Spring StreetGainesville, GA 30501 · Hall County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 30501 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
$83.23 typical visit price
range $53.31 – $164.04
Typical copayment $20.80 (range $13.32 – $41.01)
Most-billed visit code 99203
Established Patient
$66.89 typical visit price
range $16.68 – $133.24
Typical copayment $16.72 (range $4.17 – $33.31)
Most-billed visit code 99213
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.

82.55/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality81.14
Promoting Interoperability100
Improvement Activities40
Cost60.7

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 Donald Campbell's NPI number?

The NPI number for Donald Campbell is 1225185028. It was assigned to this individual provider in the NPPES registry on January 4, 2007.

Where is Donald Campbell located?

Donald Campbell practices at 1296 Sims St. Suite B, Gainesville, GA 30501. The listed phone number is (770) 534-1856.

What is Donald Campbell's specialty?

The primary specialty registered for this NPI is Plastic Surgery with taxonomy code 208200000X.

Is Donald Campbell enrolled in Medicare?

Yes. Donald Campbell 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 Donald Campbell accept?

Health plans from Alliant Health Plans, Inc. list Donald Campbell 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 Donald Campbell affiliated with any hospitals?

According to CMS data, Donald Campbell is affiliated with Northeast Georgia Medical Center, Inc.

When was this NPI record last updated?

The NPPES record for Donald Campbell was last updated on July 21, 2020. NPI Profile syncs with the weekly NPPES data releases published by CMS.