MR. BRENDAN GROARKE D.O.
NPI 1316041783
Hospitalist in Athens, GA

Active since September 07, 2006PECOS EnrolledAccepts Medicare Assignment
1199 PRINCE AVE, ATHENS, GA 30606(706) 475-7000 Get Directions Write a Review

NPPES record last updated: June 13, 2018. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Mr. Brendan Groarke D.o. NPPES

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

MR. BRENDAN GROARKE D.O. (NPI 1316041783) is an individual hospitalist provider in Athens, Georgia, licensed in Georgia (050172) and active in the NPI registry since September 2006. He is enrolled in Medicare PECOS, is affiliated with Piedmont Newton Hospital, and is a graduate of New York College Of Osteo Medicine Of New York Institute Of Technology (1996).

NPPES Registry Identity

NPI1316041783
Entity TypeIndividualMale
Primary Taxonomy208M00000X
Provider Legal NameMR. BRENDAN GROARKECredential: D.O.
Location Address1199 PRINCE AVEAthens, GA 30606
Mailing Address2727 Paces Ferry Rd Se Ste 1-1100Atlanta, GA 30339-6151 · (706) 475-7000
Sole ProprietorNo
Medical School CMSNew York College Of Osteo Medicine Of New York Institute Of TechnologyGraduated 1996
Enumeration DateSeptember 7, 2006
Last NPPES UpdateJune 13, 2018
NPI 1316041783 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyHospitalistAllopathic & Osteopathic Physicians
Taxonomy Code208M00000X
License Licensed in GA · 050172
Definition
Hospitalists are physicians whose primary professional focus is the general medical care of hospitalized patients. Their activities include patient care, teaching, research, and leadership related to Hospital Medicine. The term 'hospitalist' refers to physicians whose practice emphasizes providing care for hospitalized patients.
Also ListedInternal MedicineTaxonomy 207R00000X · License 050172 (GA)
1199 PRINCE AVE, Athens, GA 30606

Other Identifiers 4

Other110226837GA · Rr Mcare
Other868695GA · Bcbs
Medicaid000912216AGA
Other7702369GA · Aetna

Accepted 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

Mr. Brendan Groarke D.o. 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 ID9931252038
PECOS Enrollment IDI20090807000242
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 5

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.

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232
Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.
302 services146 patients
Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes 99233
Follow-up hospital inpatient care per day typically involves a 35-minute check-up by your healthcare provider. This service includes monitoring your health progress, adjusting your treatment plan if needed, and answering any questions you may have about your condition or care.
291 services185 patients
Hospital discharge day management, more than 30 minutes 99239
Hospital discharge day management over 30 minutes involves a detailed process to ensure a smooth transition from hospital to home. It includes final examinations, discussion of your hospital stay, post-discharge instructions, and coordinating follow-up care.
168 services165 patients
Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes 99223
Initial hospital inpatient care per day, typically 70 minutes, refers to the daily medical service provided to patients admitted to the hospital. This includes a comprehensive evaluation, diagnosis, treatment plan, and monitoring of your health condition. It ensures your well-being during your hospital stay.
91 services91 patients
Hospital discharge day management, 30 minutes or less 99238
Hospital discharge day management of 30 minutes or less includes finalizing your treatment, discussing your progress, and planning after-care at home. It ensures you're ready to leave the hospital and continue recovery safely.
21 services21 patients

Hospital Affiliations CMS Care Compare 2

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 Athens Regional Medical Center

Acute Care Hospitals · Athens, GA
4/5 CMS rating
OwnershipVoluntary non-profit - Other
CMS Certification Number110074
Location1199 Prince AvenueAthens, GA 30606 · Clarke County
Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 30606 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

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…
99%162 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 2

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

Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing E0431
DME-Oxygen and Supplies · category DC000N
3 suppliers22 claims22 services$18.53 avg. paid by Medicare
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390
DME-Oxygen and Supplies · category DC002N
3 suppliers22 claims22 services$98.24 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.

Neurological Surgery
1199 PRINCE AVE
ATHENS, GA 30606
Hospitalist
1199 PRINCE AVE
ATHENS, GA 30606
Nurse Anesthetist, Certified Registered
1199 PRINCE AVE
ATHENS, GA 30606
Physician Assistant
1199 PRINCE AVE
ATHENS, GA 30606
Anesthesiology
1199 PRINCE AVE
ATHENS, GA 30606
Anesthesiologist Assistant
1199 PRINCE AVE
ATHENS, GA 30606
Specialist/Technologist, Other (Surgical Assistant)
1199 PRINCE AVE
ATHENS, GA 30606
Internal Medicine (Cardiovascular Disease)
1199 PRINCE AVE
ATHENS, GA 30606

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 Brendan Groarke's NPI number?

The NPI number for Brendan Groarke is 1316041783. It was assigned to this individual provider in the NPPES registry on September 7, 2006.

Where is Brendan Groarke located?

Brendan Groarke practices at 1199 Prince Ave, Athens, GA 30606. The listed phone number is (706) 475-7000.

What is Brendan Groarke's specialty?

The primary specialty registered for this NPI is Hospitalist with taxonomy code 208M00000X.

Is Brendan Groarke enrolled in Medicare?

Yes. Brendan Groarke 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 Brendan Groarke accept?

Health plans from Alliant Health Plans, Inc. list Brendan Groarke 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 Brendan Groarke affiliated with any hospitals?

According to CMS data, Brendan Groarke is affiliated with Piedmont Newton Hospital and Piedmont Athens Regional Medical Center.

When was this NPI record last updated?

The NPPES record for Brendan Groarke was last updated on June 13, 2018. NPI Profile syncs with the weekly NPPES data releases published by CMS.