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DR. ARTHUR L. RAINES JR. M.D.
NPI 1235126160
Orthopaedic Surgery in Atlanta, GA

Active since October 05, 2005PECOS EnrolledAccepts Medicare Assignment
92.93/100
CMS Quality Rating
550 PEACHTREE ST, 19TH FLOOR, ATLANTA, GA 30308(404) 215-2000(404) 215-2001 Get Directions Write a Review

NPPES record last updated: February 21, 2011. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Dr. Arthur L. Raines Jr. M.d. NPPES

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

DR. ARTHUR L. RAINES JR. M.D. (NPI 1235126160) is an individual orthopaedic surgery provider in Atlanta, Georgia, licensed in Georgia (052209) and active in the NPI registry since October 2005. He is enrolled in Medicare PECOS, is affiliated with Saint Joseph's Hospital Of Atlanta, Inc, and is a graduate of University Of Michigan Medical School (1985).

NPPES Registry Identity

NPI1235126160
Entity TypeIndividualMale
Primary Taxonomy207X00000X
Provider Legal NameDR. ARTHUR L. RAINES JR.Credential: M.D.
Location Address550 PEACHTREE ST, 19TH FLOORAtlanta, GA 30308
Mailing Address550 Peachtree St, 19th FloorAtlanta, GA 30308 · (404) 215-2000 · Fax (404) 215-2001
Phone(404) 215-2000
Fax(404) 215-2001
Sole ProprietorNo
Medical School CMSUniversity Of Michigan Medical SchoolGraduated 1985
Enumeration DateOctober 5, 2005
Last NPPES UpdateFebruary 21, 2011
✔ NPI 1235126160 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOrthopaedic SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code207X00000X
License✔ Licensed in GA · 052209
Definition

An orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system.

550 PEACHTREE ST, Atlanta, GA 30308
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Other Identifiers 4

Medicare PIN20BBFPBGA
Medicaid000972287DGA
Medicaid000972287CGA
Medicare UPINF00416GA

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

Dr. Arthur L. Raines Jr. 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 ID1759440340
PECOS Enrollment IDI20081112000095
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 11

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 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.
175 services108 patients
X-ray of knee, 3 views 73562
An X-ray of the knee, 3 views, is a non-invasive imaging test. It uses a small amount of radiation to produce images of the knee from three different angles. This helps medical professionals to diagnose and monitor conditions like arthritis, fractures, or infections. The process is quick and painless.
108 services75 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.
98 services92 patients
Aspiration and/or injection of fluid from large joint 20610
This procedure involves using a needle to remove (aspiration) or introduce (injection) fluid into a large joint like the knee or hip. It can help diagnose conditions, relieve discomfort, or deliver medication directly to the joint.
72 services50 patients
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.
63 services63 patients
X-ray of shoulder, minimum of 2 views 73030
An X-ray of the shoulder, with a minimum of 2 views, is a non-invasive imaging test. It uses a small amount of radiation to produce images of your shoulder bones. This helps in diagnosing conditions like fractures, arthritis, or other abnormalities. The procedure is quick and painless.
41 services37 patients

Hospital Affiliations CMS Care Compare

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

Saint Joseph's Hospital Of Atlanta, Inc

Acute Care Hospitals · Atlanta, GA
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number110082
Location5665 Peachtree Dunwoody RoadAtlanta, GA 30342 · Fulton County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 30308 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
$70.85 typical visit price
range $18.22 – $140.40
Typical copayment $17.71 (range $4.55 – $35.10)
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.

92.93/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality80.38
Promoting Interoperability100
Improvement Activities40

Reported Quality Measures

Closing the Referral Loop: Receipt of Specialist Report
Percentage of patients with referrals, regardless of age, for which the referring provider receives a report from the provider to whom the patient was referred
1%488 patients1/55-star benchmark: 95%
Documentation of Current Medications in the Medical Record
Percentage of visits for patients aged 18 years and older for which the eligible professional or eligible clinician attests to documenting a list of current medications using all immediate resources available on the date of the encounter.
79%2,501 patients2/55-star benchmark: 100%
e-Prescribing
At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.
91%1,377 patients3/55-star benchmark: 99%
Medication Reconciliation
The MIPS eligible clinician performs medication reconciliation for at least one transition of care in which the patient is transitioned into the care of the MIPS eligible clinician.
95%718 patients4/55-star benchmark: 100%
Patient-Specific Education
The MIPS eligible clinician must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide access to those materials to at least one unique patient seen by the MIPS eligible clinician.
38%1,367 patients2/55-star benchmark: 97%
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan
Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the previous twelve months AND with a BMI outside of normal parameters, a follow-up plan is documented during the encounter or during the previous…
17%1,302 patients1/55-star benchmark: 97%
Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention
Percentage of patients aged 18 years and older who were screened for tobacco use one or more times within 24 months AND who received tobacco cessation intervention if identified as a tobacco user
Patients screenedForUse: 93% · 470 patients
87%470 patients4/55-star benchmark: 98%
Provide Patient Access
At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician's discretion to withhold…
72%1,367 patients3/55-star benchmark: 100%
Secure Messaging
For at least one unique patient seen by the MIPS eligible clinician during the performance period, a secure message was sent using the electronic messaging function of CEHRT to the patient (or the patient-authorized representative), or in response to a secure…
6%1,367 patients1/55-star benchmark: 89%
View, Download, or Transmit (VDT)
At least one patient seen by the MIPS eligible clinician during the performance period (or patient-authorized representative) views, downloads or transmits their health information to a third party during the performance period.
32%1,367 patients
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.

Neuromuscular stimulator, electronic shock unit E0745
DME-Other DME · category DE000N
1 supplier11 claims11 services$68.11 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 20

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

SCOTT EDWARDS PA
Anesthesiologist Assistant
550 PEACHTREE ST, ANESTHESIOLOGY 2ND FLOOR
ATLANTA, GA 30308
Fulton County (404) 778-4852
CAROL A GOURLEY CNM
Midwife
550 PEACHTREE ST
ATLANTA, GA 30308
Fulton County (404) 686-3643
STEVEN C BUCHMAN MD
Anesthesiology
550 PEACHTREE ST
ATLANTA, GA 30308
Fulton County (404) 778-4852
JOHN ROBERT MOLINARO M.D.
Internal Medicine (Gastroenterology)
550 PEACHTREE ST, STE 1600
ATLANTA, GA 30308
Fulton County (404) 253-6820
MARK SEAN BENNETT CRNA
Nurse Anesthetist, Certified Registered
550 PEACHTREE ST, SUITE 1600
ATLANTA, GA 30308
Fulton County (404) 253-6820
JENNIFER ETKIND MD
Anesthesiology
550 PEACHTREE ST, ANESTHESIOLOGY MOT 2
ATLANTA, GA 30308
Fulton County (404) 778-4852
GITA KAMRAN PA
Anesthesiologist Assistant
550 PEACHTREE ST
ATLANTA, GA 30308
Fulton County (404) 778-4852
JAMES STAPLES MD
Anesthesiology
550 PEACHTREE ST
ATLANTA, GA 30308
Fulton County (404) 778-4852

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 Arthur Raines's NPI number?

The NPI number for Arthur Raines is 1235126160. It was assigned to this individual provider in the NPPES registry on October 5, 2005.

Where is Arthur Raines located?

Arthur Raines practices at 550 Peachtree St 19th Floor, Atlanta, GA 30308. The listed phone number is (404) 215-2000.

What is Arthur Raines's specialty?

The primary specialty registered for this NPI is Orthopaedic Surgery with taxonomy code 207X00000X.

Is Arthur Raines enrolled in Medicare?

Yes. Arthur Raines 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.

Is Arthur Raines affiliated with any hospitals?

According to CMS data, Arthur Raines is affiliated with Saint Joseph's Hospital Of Atlanta, Inc.

When was this NPI record last updated?

The NPPES record for Arthur Raines was last updated on February 21, 2011. NPI Profile syncs with the weekly NPPES data releases published by CMS.