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ANDREA R MILES M.D.
NPI 1275523045
Pediatrics in Mcdonough, GA

Active since October 24, 2005PECOS EnrolledAccepts Medicare Assignment
90.8/100
CMS Quality Rating
101 REGENCY PARK DR, SUITE 150, MCDONOUGH, GA 30253(770) 957-4195(770) 898-6337 Get Directions Write a Review

NPPES record last updated: September 12, 2016. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Andrea R Miles M.d. NPPES

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

ANDREA R MILES M.D. (NPI 1275523045) is an individual pediatrics provider in Mcdonough, Georgia, licensed in Georgia (54318) and active in the NPI registry since October 2005. She is enrolled in Medicare PECOS, is affiliated with Piedmont Newton Hospital, and is a graduate of Wright State University Boonshoft School Of Medicine (2004).

NPPES Registry Identity

NPI1275523045
Entity TypeIndividualFemale
Primary Taxonomy208000000X
Provider Legal NameANDREA R MILESCredential: M.D.
Location Address101 REGENCY PARK DR, SUITE 150Mcdonough, GA 30253-7080
Mailing Address101 Regency Park Dr, Suite 150Mcdonough, GA 30253-7080 · (770) 957-4195 · Fax (770) 898-6337
Phone(770) 957-4195
Fax(770) 898-6337
Sole ProprietorNo
Medical School CMSWright State University Boonshoft School Of MedicineGraduated 2004
Enumeration DateOctober 24, 2005
Last NPPES UpdateSeptember 12, 2016
✔ NPI 1275523045 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians
Taxonomy Code208000000X
License✔ Licensed in GA · 54318
Definition

A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.

Also ListedInternal MedicineTaxonomy 207R00000X · License 54318 (GA)
101 REGENCY PARK DR, Mcdonough, GA 30253
Open in Google Maps ↗

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Alliant Health Plans, Inc., Ambetter from Absolute Total Care, Ambetter Health 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

Andrea R Miles 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 ID345295473
PECOS Enrollment IDI20050322000254
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 8

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.
119 services74 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.
56 services56 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.
37 services28 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.
31 services21 patients
Blood glucose (sugar) test performed by hand-held instrument 82962
A blood glucose test uses a handheld device to measure the amount of sugar in your blood. A small prick on your finger allows a drop of blood to be placed on a test strip, which is then read by the device. This helps monitor and manage diabetes effectively.
27 services20 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.
16 services16 patients

Hospital Affiliations CMS Care Compare 3

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

Piedmont Newton Hospital

Acute Care Hospitals · Covington, GA
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number110018
Location5126 Hospital Drive NECovington, GA 30014 · Newton County
Emergency services Birthing friendly

Piedmont Rockdale Hospital

Acute Care Hospitals · Conyers, GA
2/5 CMS rating
OwnershipProprietary
CMS Certification Number110091
Location1412 Milstead Avenue, NEConyers, GA 30012 · Rockdale County
Birthing friendly

Piedmont Henry Hospital

Acute Care Hospitals · Stockbridge, GA
2/5 CMS rating
OwnershipGovernment - Hospital District or Authority
CMS Certification Number110191
Location1133 Eagle's Landing ParkwayStockbridge, GA 30281 · Henry County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 30253 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.

90.8/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Promoting Interoperability98
Improvement Activities20

Reported Quality Measures

Care Plan
Percentage of patients aged 65 years and older who have an advance care plan or surrogate decision maker documented in the medical record that an advance care plan was discussed but the patient did not wish or was not able to name a surrogate decision maker…
11%145 patients1/55-star benchmark: 100%
Colorectal Cancer Screening
Percentage of adults 50-75 years of age who had appropriate screening for colorectal cancer
57%116 patients3/55-star benchmark: 100%
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
4%23 patients1/55-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
74%148 patients3/55-star benchmark: 100%
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…
99%172 patients4/55-star benchmark: 100%
Preventive Care and Screening: Screening for Depression and Follow-Up Plan
Percentage of patients aged 12 years and older screened for depression on the date of the encounter using an age appropriate standardized depression screening tool AND if positive, a follow-up plan is documented on the date of the positive screen
58%157 patients3/55-star benchmark: 100%
Screening for Osteoporosis for Women Aged 65-85 Years of Age
Percentage of female patients aged 65-85 years of age who ever had a central dual-energy X-ray absorptiometry (DXA) to check for osteoporosis
74%78 patients4/55-star benchmark: 98%
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.

Other Providers at the Same Location NPPES 8

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

KIMBERLY PURCELL
Nurse Practitioner (Pediatrics)
101 REGENCY PARK DR, SUITE 140
MCDONOUGH, GA 30253
Henry County (770) 957-8626
DR. JIM WAYNE LATIMER M.D.
Family Medicine
101 REGENCY PARK DR, SUITE 150
MCDONOUGH, GA 30253
Henry County (770) 957-4195
SHUVORY CHYANN GREEN FNP-C
Nurse Practitioner (Family)
101 REGENCY PARK DR
MCDONOUGH, GA 30253
Henry County (404) 996-0126
KEVIN M KUREY MD PC
Family Medicine
101 REGENCY PARK DR, STE 130
MCDONOUGH, GA 30253
Henry County (770) 957-3935
MCDONOUGH PEDIATRICS
Pediatrics
101 REGENCY PARK DR, STE 140
MCDONOUGH, GA 30253
Henry County (770) 957-8626
GEORGE ARISTIDE MD
Emergency Medicine (Emergency Medical Services)
101 REGENCY PARK DR
MCDONOUGH, GA 30253
Henry County (770) 994-9326
INDIA K. ROBINSON MD
Family Medicine
101 REGENCY PARK DR, SUITE 150
MCDONOUGH, GA 30253
Henry County (770) 957-4195
SEKHAR C SANKARAN MD
Pediatrics
101 REGENCY PARK DR, STE 140
MCDONOUGH, GA 30253
Henry County (770) 957-8626

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 Andrea Miles's NPI number?

The NPI number for Andrea Miles is 1275523045. It was assigned to this individual provider in the NPPES registry on October 24, 2005.

Where is Andrea Miles located?

Andrea Miles practices at 101 Regency Park Dr Suite 150, Mcdonough, GA 30253. The listed phone number is (770) 957-4195.

What is Andrea Miles's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Is Andrea Miles enrolled in Medicare?

Yes. Andrea Miles 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 Andrea Miles accept?

Health plans from Alliant Health Plans, Inc., Ambetter Health, Ambetter from Absolute Total Care, Ambetter of Alabama and Ambetter of North Carolina and 1 other insurer list Andrea Miles 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 Andrea Miles affiliated with any hospitals?

According to CMS data, Andrea Miles is affiliated with Piedmont Newton Hospital, Piedmont Rockdale Hospital and Piedmont Henry Hospital.

When was this NPI record last updated?

The NPPES record for Andrea Miles was last updated on September 12, 2016. NPI Profile syncs with the weekly NPPES data releases published by CMS.