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DR. SAMUEL JOSEPH DOLEZAL MD, PHD
NPI 1326499187
Internal Medicine in Athens, GA

Active since June 23, 2016PECOS EnrolledAccepts Medicare Assignment
95.5/100
CMS Quality Rating
3320 OLD JEFFERSON RD STE 600, ATHENS, GA 30607(706) 353-2990(706) 353-2992 Get Directions Write a Review

NPPES record last updated: November 22, 2022. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Nov 22, 2022, Feb 23, 2021, Jun 5, 2019 and 1 more (4 updates tracked since 2016).

About Dr. Samuel Joseph Dolezal Md, Phd NPPES

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

DR. SAMUEL JOSEPH DOLEZAL MD, PHD (NPI 1326499187) is an individual internal medicine provider in Athens, Georgia, licensed in Minnesota (65020) and active in the NPI registry since June 2016. He is enrolled in Medicare PECOS, is affiliated with Baptist Health Floyd, and is a graduate of Other (2016).

NPPES Registry Identity

NPI1326499187
Entity TypeIndividualMale
Primary Taxonomy207R00000X
Provider Legal NameDR. SAMUEL JOSEPH DOLEZALCredential: MD, PHD
Location Address3320 OLD JEFFERSON RD STE 600Athens, GA 30607-1463
Mailing Address3320 Old Jefferson Rd Bldg 700Athens, GA 30607-1465 · (706) 353-2990 · Fax (706) 353-2992
Phone(706) 353-2990
Fax(706) 353-2992
Sole ProprietorYes
Medical School CMSOtherGraduated 2016
Enumeration DateJune 23, 2016
Last NPPES UpdateNovember 22, 20224 updates tracked since enumeration
NPPES CertifiedNovember 22, 2022
✔ NPI 1326499187 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License✔ Licensed in MN · 65020
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.
Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X
3320 OLD JEFFERSON RD STE 600, Athens, GA 30607
Open in Google Maps ↗

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include CareSource.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

Dr. Samuel Joseph Dolezal Md, Phd 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 ID6800180746
PECOS Enrollment IDI20230424001951
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 10

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.
402 services242 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.
183 services156 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.
101 services101 patients
Transitional care management services for problem of at least moderate complexity 99495
Transitional care management services focus on coordinating and managing your care after you leave the hospital. For moderate complexity problems, this involves managing your medications, arranging further treatments, and ensuring you have the necessary follow-ups.
35 services32 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.
30 services30 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.
28 services28 patients

Hospital Affiliations CMS Care Compare 2

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

Baptist Health Floyd

Acute Care Hospitals · New Albany, IN
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number150044
Location1850 State StNew Albany, IN 47150 · Floyd County
Emergency services Birthing friendly

Baptist Health Louisville

Acute Care Hospitals · Louisville, KY
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number180130
Location4000 Kresge WayLouisville, KY 40207 · Jefferson County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 30607 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.

95.5/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality89.59
Promoting Interoperability100
Improvement Activities40

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.

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
1 supplier11 claims11 services$68.80 avg. paid by Medicare
Portable oxygen concentrator, rental E1392
DME-Oxygen and Supplies · category DC002N
1 supplier11 claims11 services$35.59 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.

KRYSTLE WILLIAMS SWAIN PA-C
Physician Assistant
3320 OLD JEFFERSON RD STE 600
ATHENS, GA 30607
Clarke County (762) 356-4933
ATHENS DIABETES AND ENDOCRINOLOGY
Internal Medicine (Endocrinology, Diabetes & Metabolism)
3320 OLD JEFFERSON RD STE 600
ATHENS, GA 30607
Clarke County (706) 549-4155

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 Samuel Dolezal's NPI number?

The NPI number for Samuel Dolezal is 1326499187. It was assigned to this individual provider in the NPPES registry on June 23, 2016.

Where is Samuel Dolezal located?

Samuel Dolezal practices at 3320 Old Jefferson Rd Ste 600, Athens, GA 30607. The listed phone number is (706) 353-2990.

What is Samuel Dolezal's specialty?

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

Is Samuel Dolezal enrolled in Medicare?

Yes. Samuel Dolezal 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 Samuel Dolezal accept?

Health plans from CareSource list Samuel Dolezal 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 Samuel Dolezal affiliated with any hospitals?

According to CMS data, Samuel Dolezal is affiliated with Baptist Health Floyd and Baptist Health Louisville.

When was this NPI record last updated?

The NPPES record for Samuel Dolezal was last updated on November 22, 2022. 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.