EDWIN B TIRADO JR. MD
NPI 1265428312
Internal Medicine in Gainesville, GA

Q: What is Edwin Tirado's NPI number?

The NPI number for Edwin Tirado is 1265428312. It was assigned to this individual provider in the NPPES registry on September 23, 2005.

Q: What is Edwin Tirado'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 Edwin Tirado was last updated on October 13, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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 September 23, 2005PECOS EnrolledAccepts Medicare Assignment

82.55/100

CMS Quality Rating

1315 JESSE JEWELL PKWY NE, SUITE #110, GAINESVILLE, GA 30501(770) 219-0023(770) 219-0694 Get Directions Write a Review

NPPES record last updated: October 13, 2020. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Oct 13, 2020, Dec 21, 2015 (2 updates tracked since 2015).

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About Edwin B Tirado Jr. Md NPPES

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

EDWIN B TIRADO JR. MD (NPI 1265428312) is an individual internal medicine provider in Gainesville, Georgia, licensed in Georgia (061866) and active in the NPI registry since September 2005. He is enrolled in Medicare PECOS, is affiliated with Northeast Georgia Medical Center, Inc, and is a graduate of Other (1997).

NPPES Registry Identity

NPI1265428312

Entity TypeIndividualMale

Primary Taxonomy207R00000X

Provider Legal NameEDWIN B TIRADO JR.Credential: MD

Location Address1315 JESSE JEWELL PKWY NE, SUITE #110Gainesville, GA 30501-3822

Mailing AddressPo Box 742616Atlanta, GA 30374-2616 · (770) 219-8420 · Fax (770) 219-8440

Phone(770) 219-0023

Fax(770) 219-0694

Sole ProprietorNo

Medical School CMSOtherGraduated 1997

Enumeration DateSeptember 23, 2005

Last NPPES UpdateOctober 13, 20202 updates tracked since enumeration

NPPES CertifiedOctober 13, 2020

✔ NPI 1265428312 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207R00000X

License✔ Licensed in GA · 061866

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.

1315 JESSE JEWELL PKWY NE, 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

Edwin B Tirado Jr. 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 ID7315837143

PECOS Enrollment IDI20100422000985

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 18

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.

411 services208 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.

330 services208 patients

Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439

An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.

120 services120 patients

Hemoglobin a1c level 83036

Hemoglobin A1c (HbA1c) is a test that measures your average blood sugar level over the past 2-3 months. It's used to monitor how well diabetes is being controlled. High levels may indicate that your diabetes treatment plan needs adjustment.

115 services72 patients

Administration of influenza virus vaccine G0008

The administration of the influenza virus vaccine, also known as the flu shot, is a simple procedure to protect against the flu. A healthcare provider injects a small dose of the vaccine into your arm. This stimulates your immune system to produce antibodies, which will help your body fight off the flu if exposed.

52 services51 patients

Influenza vaccine split virus, preservative free 90662

The Influenza Vaccine Split Virus, preservative-free, is a flu shot to protect against the influenza virus. It is made from parts of inactivated flu viruses and doesn't contain preservatives, reducing potential side effects. It helps your body develop immunity to the flu.

47 services46 patients

Office or other outpatient visit for the evaluation and management of established patient that may not require presence of healthcare professional 99211

This service involves an outpatient visit for established patients who may not need direct interaction with a healthcare professional. It could include reviewing test results, monitoring existing conditions, or adjusting treatment plans. It's typically done remotely, ensuring your comfort and convenience.

34 services17 patients

Complete blood cell count (red cells, white blood cell, platelets), automated test 85027

A complete blood cell count (CBC) is an automated test that measures different components of the blood, including red cells, white cells, and platelets. It helps assess overall health, detect disorders like anemia or infection, and monitor medical treatments.

31 services31 patients

Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count 85025

A Complete Blood Cell Count is a common test that measures various components of the blood, including red cells (carry oxygen), white cells (fight infection), and platelets (help blood clot). An automated test ensures accuracy. The differential count provides detailed information about white cell types.

30 services29 patients

Automated urinalysis test 81003

An automated urinalysis test is a routine examination that checks your urine for various substances. It can help identify potential health issues such as kidney problems or diabetes. The test uses a machine to analyze a small urine sample, providing quick and accurate results.

28 services26 patients

Urine microalbumin (protein) level 82043

The urine microalbumin level test measures the amount of a protein called albumin in your urine. This test helps to detect early signs of kidney damage. High levels of albumin may suggest your kidneys aren't functioning properly. It's a simple, non-invasive test that involves providing a urine sample.

28 services27 patients

Creatinine level to test for kidney function or muscle injury 82570

A creatinine level test measures the amount of creatinine in your blood. This substance is a waste product from normal muscle use. Higher levels can indicate possible kidney dysfunction or muscle injury. This test helps monitor kidney health.

28 services27 patients

Pneumococcal conjugate vaccine, 20 valent (pcv20), for intramuscular use 90677

The Pneumococcal Conjugate Vaccine (PCV20) is a shot given to protect against 20 types of bacteria that can cause serious infections like pneumonia and meningitis. It's administered through a muscle, usually in the arm. It's important for overall health.

19 services19 patients

Continuous monitoring of blood sugar level in tissue fluid using sensor under skin with interpretation and report 95251

This procedure involves placing a small sensor under your skin to continuously monitor your blood sugar levels in tissue fluid. The data is interpreted and a report is generated to help manage your diabetes more effectively.

19 services11 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.

19 services19 patients

Administration of pneumococcal vaccine G0009

The pneumococcal vaccine helps protect against pneumococcal bacteria, which can cause severe infections like pneumonia and meningitis. The vaccine is given as an injection, typically in the arm. It's recommended for infants, older adults, and those with certain health conditions.

19 services19 patients

Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report 93000

An electrocardiogram (ECG) is a non-invasive test that records your heart's electrical activity. Using 12 leads attached to your body, it captures data to help identify heart conditions. A doctor interprets the results and provides a report.

18 services18 patients

Blood count, hemoglobin 85018

A blood count, specifically hemoglobin, is a standard test that measures the amount of hemoglobin in your blood. Hemoglobin is a protein in red blood cells that carries oxygen throughout your body. This test helps assess your overall health and detect a variety of disorders such as anemia or polycythemia.

14 services11 patients

Hospital Affiliations CMS Care Compare 2

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

Ngmc Barrow, LLC

Acute Care Hospitals · Winder, GA

OwnershipProprietary

CMS Certification Number110045

Location316 North Broad StreetWinder, GA 30680 · Barrow County

Emergency services

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

$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.

82.55/100

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

Scored as part of a group practice

Quality

81.14

Promoting Interoperability

100

Improvement Activities

Cost

60.7

Referred Medical Equipment & Supplies CMS DME claims 5

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

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253

DME-Other DME · category DE017N

12 suppliers41 claims152 services$6.56 avg. paid by Medicare

Lancets, per box of 100 A4259

DME-Medical/Surgical Supplies · category DA000N

7 suppliers16 claims36 services$1.16 avg. paid by Medicare

Standard wheelchair K0001

DME-Wheelchairs · category DD000N

2 suppliers11 claims11 services$27.06 avg. paid by Medicare

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

2 suppliers63 claims63 services$187.52 avg. paid by Medicare

Power wheelchair, group 2 standard, captains chair, patient weight capacity up to and including 300 pounds K0823

DME-Wheelchairs · category DD009N

1 supplier21 claims21 services$180.05 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 10

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

MR. DANIEL D RHOADS M.D.

Orthopaedic Surgery

1315 JESSE JEWELL PKWY NE, SUITE 300
GAINESVILLE, GA 30501

Hall County (770) 219-3202

DR. ROBERT M. WOOD M.D.

Orthopaedic Surgery

1315 JESSE JEWELL PKWY NE, SUITE 300
GAINESVILLE, GA 30501

Hall County (770) 848-6190

DR. GREGORY DENNIS JACKSON MD

Anesthesiology (Pain Medicine)

1315 JESSE JEWELL PKWY NE, SUITE 300
GAINESVILLE, GA 30501

Hall County (770) 219-6520

CATHERINE ANN CARLSON

Physician Assistant

1315 JESSE JEWELL PKWY NE
GAINESVILLE, GA 30501

Hall County (770) 219-6520

ARUN THANKACHAN JACOB M.B.B.S.

Neurological Surgery

1315 JESSE JEWELL PKWY NE, SUITE 300
GAINESVILLE, GA 30501

Hall County (770) 219-6520

DR. ANTONIO RIOS M.D.

Internal Medicine

1315 JESSE JEWELL PKWY NE, SUITE 110
GAINESVILLE, GA 30501

Hall County (770) 219-0023

DR. JAY S HORTENSTINE M.D.

Urology

1315 JESSE JEWELL PKWY NE
GAINESVILLE, GA 30501

Hall County (770) 219-6520

MRS. MARY JANE BROWN NP-C

Nurse Practitioner

1315 JESSE JEWELL PKWY NE, SUITE 300
GAINESVILLE, GA 30501

Hall County (770) 219-6520

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 Edwin Tirado's NPI number?

The NPI number for Edwin Tirado is 1265428312. It was assigned to this individual provider in the NPPES registry on September 23, 2005.

Where is Edwin Tirado located?

Edwin Tirado practices at 1315 Jesse Jewell Pkwy NE Suite #110, Gainesville, GA 30501. The listed phone number is (770) 219-0023.

What is Edwin Tirado's specialty?

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

Is Edwin Tirado enrolled in Medicare?

Yes. Edwin Tirado 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 Edwin Tirado accept?

Health plans from Alliant Health Plans, Inc. list Edwin Tirado 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 Edwin Tirado affiliated with any hospitals?

According to CMS data, Edwin Tirado is affiliated with Northeast Georgia Medical Center, Inc and Ngmc Barrow, LLC.

When was this NPI record last updated?

The NPPES record for Edwin Tirado was last updated on October 13, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.