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BARRY M ZISHOLTZ M.D.
NPI 1265441349
Urology in Riverdale, GA

Active since August 06, 2006PECOS Enrolled
76.25/100
CMS Quality Rating
33 UPPER RIVERDALE RD SW, SUITE 105, RIVERDALE, GA 30274(770) 991-0020(770) 994-9729 Get Directions Write a Review

NPPES record last updated: March 7, 2023. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Mar 7, 2023, Aug 11, 2020 (2 updates tracked since 2020).

About Barry M Zisholtz M.d. NPPES

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

BARRY M ZISHOLTZ M.D. (NPI 1265441349) is an individual urology provider in Riverdale, Georgia, licensed in Georgia (030698) and active in the NPI registry since August 2006. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1265441349
Entity TypeIndividualMale
Primary Taxonomy208800000X
Provider Legal NameBARRY M ZISHOLTZCredential: M.D.
Location Address33 UPPER RIVERDALE RD SW, SUITE 105Riverdale, GA 30274-2626
Mailing Address1930 Brannan RdMcdonough, GA 30253-4310 · (678) 284-4040 · Fax (678) 284-4076
Phone(770) 991-0020
Fax(770) 994-9729
Sole ProprietorNo
Enumeration DateAugust 6, 2006
Last NPPES UpdateMarch 7, 20232 updates tracked since enumeration
NPPES CertifiedAugust 11, 2020
✔ NPI 1265441349 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyUrologyAllopathic & Osteopathic Physicians
Taxonomy Code208800000X
License✔ Licensed in GA · 030698
Definition
A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures.
33 UPPER RIVERDALE RD SW, Riverdale, GA 30274
Open in Google Maps ↗

Other Identifiers 2

Other340008499GA · Railroad Medicare
Medicaid000441867AGA

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, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Barry M Zisholtz M.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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 Reassignments

2

Medicare enrollment records show Barry Zisholtz reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Georgia Urology PA
Same address
Urology
33 UPPER RIVERDALE RD SW, SUITE 105
Riverdale, GA 30274
  • Reassigned Medicare billing, Georgia enrollment
  • 115 clinicians in this Medicare group
NPI 1245250646 (770) 991-0020
Urological Professional Services, LLC
23 mi
Urology
1000 JOHNSON FY RD NE
Atlanta, GA 30342
  • Reassigned Medicare billing, Georgia enrollment
  • 95 clinicians in this Medicare group
NPI 1033521810 (855) 709-4535

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

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 30274 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
$130.64 typical visit price
range $56.84 – $172.43
Typical copayment $32.66 (range $14.21 – $43.10)
Most-billed visit code 99204
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.

76.25/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality54.88
Promoting Interoperability97
Improvement Activities40
Cost68.46

Reported Quality Measures

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.
94%2,715 patients4/55-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.
63%190 patients3/55-star benchmark: 100%
Health Information Exchange
The MIPS eligible clinician that transitions or refers their patient to another setting of care or health care clinician (1) uses CEHRT to create a summary of care record; and (2) electronically transmits such summary to a receiving health care clinician for…
37%174 patients2/55-star benchmark: 98%
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.
84%199 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.
76%606 patients4/55-star benchmark: 100%
Pneumococcal Vaccination Status for Older Adults
Percentage of patients 65 years of age and older who have ever received a pneumococcal vaccine
41%697 patients2/55-star benchmark: 90%
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…
80%1,307 patients4/55-star benchmark: 97%
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
28%653 patients2/55-star benchmark: 88%
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…
52%619 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…
41%619 patients3/55-star benchmark: 79%
Urinary Incontinence: Assessment of Presence or Absence of Urinary Incontinence in Women Aged 65 Years and Older
Percentage of female patients aged 65 years and older who were assessed for the presence or absence of urinary incontinence within 12 months
93%274 patients4/55-star benchmark: 100%
Use of High-Risk Medications in the Elderly
Percentage of patients 65 years of age and older who were ordered high-risk medications. Two rates are submitted. 1) Percentage of patients who were ordered at least one high-risk medication.
Lower rates are better for this measure.
Patients 2+: 0% · 697 patients
1%697 patients4/55-star benchmark: 100%
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.

Intermittent urinary catheter; coude (curved) tip, with or without coating (teflon, silicone, silicone elastomeric, or hydrophilic, etc.), each A4352
DME-Orthotic Devices · category DF008N
2 suppliers13 claims990 services$6.11 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.

GLENN S SHEAR MDPC
Specialist
33 UPPER RIVERDALE RD SW, SUITE 114
RIVERDALE, GA 30274
Clayton County (770) 991-1624
OKEH HEALTH GROUP, LLC
Internal Medicine
33 UPPER RIVERDALE RD SW, 17
RIVERDALE, GA 30274
Clayton County (770) 897-7043
DR. MICHAEL ANGEL DICRISTINA M.D.
Internal Medicine
33 UPPER RIVERDALE RD SW, SUITE 21
RIVERDALE, GA 30274
Clayton County (770) 968-7933
SOUTHERN CRESCENT PHYSICIANS GROUP, INC.
Orthopaedic Surgery
33 UPPER RIVERDALE RD SW, SUITE 17
RIVERDALE, GA 30274
Clayton County (770) 897-7056
RADIOLOGY ASSOCIATES OF CLAYTON, P.C.
Radiology (Diagnostic Radiology)
33 UPPER RIVERDALE RD SW, SUITE 105
RIVERDALE, GA 30274
Clayton County (770) 991-9729
ROBIN ALVERSON INC
Audiologist
33 UPPER RIVERDALE RD SW, STE 117
RIVERDALE, GA 30274
Clayton County (770) 991-1170
MATTHEW EDWIN DAVIS M.D.
Otolaryngology
33 UPPER RIVERDALE RD SW, SUITE 117
RIVERDALE, GA 30274
Clayton County (770) 991-1170
GEORGIA UROLOGY PA
Urology
33 UPPER RIVERDALE RD SW, SUITE 105
RIVERDALE, GA 30274
Clayton County (770) 991-0020

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 Barry Zisholtz's NPI number?

The NPI number for Barry Zisholtz is 1265441349. It was assigned to this individual provider in the NPPES registry on August 6, 2006.

Where is Barry Zisholtz located?

Barry Zisholtz practices at 33 Upper Riverdale Rd SW Suite 105, Riverdale, GA 30274. The listed phone number is (770) 991-0020.

What is Barry Zisholtz's specialty?

The primary specialty registered for this NPI is Urology with taxonomy code 208800000X.

Is Barry Zisholtz enrolled in Medicare?

Yes. Barry Zisholtz is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Barry Zisholtz's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Barry Zisholtz reassigns Medicare benefits to 2 organizations: Georgia Urology PA (Riverdale, GA) and Urological Professional Services, LLC (Atlanta, GA). Each 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 Barry Zisholtz's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Barry Zisholtz accept?

Health plans from Ambetter Health, Ambetter from Absolute Total Care, Ambetter of Alabama, Ambetter of North Carolina and Ambetter of Tennessee list Barry Zisholtz 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.

When was this NPI record last updated?

The NPPES record for Barry Zisholtz was last updated on March 7, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.