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THOMAS WILLIAM PRICE MD
NPI 1285610055
Internal Medicine in Macon, GA

Active since December 22, 2005PECOS EnrolledAccepts Medicare Assignment
458 HEMLOCK ST STE 100B, MACON, GA 31201(478) 741-5945(478) 743-5890 Get Directions Write a Review

NPPES record last updated: August 5, 2025. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Aug 5, 2025, Sep 8, 2022 (2 updates tracked since 2022).

About Thomas William Price Md NPPES

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

THOMAS WILLIAM PRICE MD (NPI 1285610055) is an individual internal medicine provider in Macon, Georgia, licensed in Georgia (030662) and active in the NPI registry since December 2005. He is enrolled in Medicare PECOS, is affiliated with Atrium Health Navicent The Medical Center, and is a graduate of Medical College Of Georgia School Of Medicine (1985).

NPPES Registry Identity

NPI1285610055
Entity TypeIndividualMale
Primary Taxonomy207R00000X
Provider Legal NameTHOMAS WILLIAM PRICECredential: MD
Location Address458 HEMLOCK ST STE 100BMacon, GA 31201-4200
Mailing Address458 Hemlock St Ste 100bMacon, GA 31201-4200 · (478) 741-5945 · Fax (478) 743-5890
Phone(478) 741-5945
Fax(478) 743-5890
Sole ProprietorYes
Medical School CMSMedical College Of Georgia School Of MedicineGraduated 1985
Enumeration DateDecember 22, 2005
Last NPPES UpdateAugust 5, 20252 updates tracked since enumeration
NPPES CertifiedAugust 5, 2025
✔ NPI 1285610055 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 · 030662
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.
458 HEMLOCK ST STE 100B, Macon, GA 31201
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Other Identifiers 1

Medicaid000367628AGA

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Alliant Health Plans, Inc., Oscar Health, Oscar Insurance Company.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Thomas William Price 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 ID4486647484
PECOS Enrollment IDI20040406000548
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 Reassignment

Medicare enrollment records show Thomas Price reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Central Georgia Infectious Diseases Associates, LLC
Same address
Infectious Disease
458 HEMLOCK ST STE 100B
Macon, GA 31201
  • Reassigned Medicare billing, Georgia enrollment
  • 2 clinicians in this Medicare group
NPI 1932283868 (478) 741-5945

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

Areas of Expertise CMS Part B claims 3

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.
354 services151 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
Annual depression screening, 5 to 15 minutes G0444
An annual depression screening is a short, routine evaluation to check for signs of depression. It involves answering a series of questions about your feelings, thoughts, and behaviors. The process takes about 15 minutes and helps detect depression early for better management.
46 services46 patients

Hospital Affiliations CMS Care Compare

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

Atrium Health Navicent The Medical Center

Acute Care Hospitals · Macon, GA
1/5 CMS rating
OwnershipGovernment - Hospital District or Authority
CMS Certification Number110107
Location777 Hemlock StreetMacon, GA 31201 · Bibb County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 31201 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.

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.
100%1,864 patients5/55-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.
50%1,538 patients2/55-star benchmark: 100%
Falls: Plan of Care
Percentage of patients aged 65 years and older with a history of falls that had a plan of care for falls documented within 12 months
100%45 patients5/55-star benchmark: 100%
Falls: Risk Assessment
Percentage of patients aged 65 years and older with a history of falls that had a risk assessment for falls completed within 12 months
100%45 patients5/55-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…
7%117 patients1/55-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.
100%20 patients5/55-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.
6%378 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
4%356 patients1/55-star benchmark: 95%
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%840 patients4/55-star benchmark: 100%
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
74%86 patients3/55-star benchmark: 100%
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…
85%378 patients4/55-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…
65%378 patients4/55-star benchmark: 79%
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.

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
1 supplier12 claims12 services$208.26 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 2

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

QUYEN NGOC LUU MD
Internal Medicine (Infectious Disease)
458 HEMLOCK ST STE 100B
MACON, GA 31201
Bibb County (478) 741-5945
CENTRAL GEORGIA INFECTIOUS DISEASES ASSOCIATES, LLC
Internal Medicine (Infectious Disease)
458 HEMLOCK ST STE 100B
MACON, GA 31201
Bibb County (478) 741-5945

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 Thomas Price's NPI number?

The NPI number for Thomas Price is 1285610055. It was assigned to this individual provider in the NPPES registry on December 22, 2005.

Where is Thomas Price located?

Thomas Price practices at 458 Hemlock St Ste 100B, Macon, GA 31201. The listed phone number is (478) 741-5945.

What is Thomas Price's specialty?

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

Is Thomas Price enrolled in Medicare?

Yes. Thomas Price 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.

Which organization bills Medicare for Thomas Price's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Thomas Price reassigns Medicare benefits to Central Georgia Infectious Diseases Associates, LLC (Macon, GA). The 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 Thomas Price's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Thomas Price accept?

Health plans from Alliant Health Plans, Inc., Oscar Health and Oscar Insurance Company list Thomas Price 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 Thomas Price affiliated with any hospitals?

According to CMS data, Thomas Price is affiliated with Atrium Health Navicent The Medical Center.

When was this NPI record last updated?

The NPPES record for Thomas Price was last updated on August 5, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 months 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.