JUAN CARLOS CADAVID SEPULVEDA MD.
NPI 1346455425
Internal Medicine - Pulmonary Disease in Cumming, GA

Q: What is Juan Cadavid Sepulveda's NPI number?

The NPI number for Juan Cadavid Sepulveda is 1346455425. It was assigned to this individual provider in the NPPES registry on May 11, 2007.

Q: What is Juan Cadavid Sepulveda's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Pulmonary Disease, with taxonomy code 207RP1001X.

Active since May 11, 2007PECOS EnrolledAccepts Medicare Assignment

84.15/100

CMS Quality Rating

1505 NORTHSIDE BLVD STE 3500, CUMMING, GA 30041(770) 292-3120(770) 292-3121 Get Directions Write a Review

NPPES record last updated: May 8, 2021. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: May 8, 2021, Apr 26, 2021 (2 updates tracked since 2021).

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About Juan Carlos Cadavid Sepulveda Md. NPPES

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

JUAN CARLOS CADAVID SEPULVEDA MD. (NPI 1346455425) is an individual pulmonary disease provider in Cumming, Georgia, licensed in Georgia (068126) and active in the NPI registry since May 2007. He is enrolled in Medicare PECOS, is affiliated with Northside Hospital Forsyth, and is a graduate of Other (2007).

NPPES Registry Identity

NPI1346455425

Entity TypeIndividualMale

Primary Taxonomy207RP1001X

Provider Legal NameJUAN CARLOS CADAVID SEPULVEDACredential: MD.

Location Address1505 NORTHSIDE BLVD STE 3500Cumming, GA 30041-8223

Mailing Address1505 Northside Blvd Ste 3500Cumming, GA 30041-8223 · (770) 292-3120 · Fax (770) 292-3121

Phone(770) 292-3120

Fax(770) 292-3121

Sole ProprietorNo

Medical School CMSOtherGraduated 2007

Enumeration DateMay 11, 2007

Last NPPES UpdateMay 8, 20212 updates tracked since enumeration

NPPES CertifiedMay 8, 2021

✔ NPI 1346455425 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal Medicine · Pulmonary DiseaseAllopathic & Osteopathic Physicians

Taxonomy Code207RP1001X

Licenses✔ Licensed in GA · 068126✔ Licensed in PA · MD 438781

Definition

An internist who treats diseases of the lungs and airways. The pulmonologist diagnoses and treats cancer, pneumonia, pleurisy, asthma, occupational and environmental diseases, bronchitis, sleep disorders, emphysema and other complex disorders of the lungs.

Also ListedInternal Medicine · Critical Care MedicineTaxonomy 207RC0200X · License 068126 (GA)

1505 NORTHSIDE BLVD STE 3500, Cumming, GA 30041

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Other Identifiers 1

Medicaid003126963BGA

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, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Juan Carlos Cadavid Sepulveda 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 ID2062540156

PECOS Enrollment IDI20120815000413

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 12

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.

331 services179 patients

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.

164 services87 patients

X-ray of chest, 2 views 71046

A chest X-ray, 2 views, is a quick, painless test that creates pictures of the structures inside your chest, such as your heart, lungs, and blood vessels. Two different angles are used to get a comprehensive view. This helps in diagnosing conditions like pneumonia, heart problems, or lung cancer.

134 services121 patients

Test to measure expiratory airflow and volume 94010

This test, known as spirometry, assesses how well your lungs work. It measures how much air you can inhale, how much you can exhale and how quickly you can exhale. It's non-invasive and helps diagnose conditions like asthma or COPD.

87 services84 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.

81 services51 patients

New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204

This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.

60 services60 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.

54 services47 patients

Test to determine lung volumes using sensors 94726

This test, called spirometry, measures lung capacity using sensors. You breathe into a mouthpiece attached to a device that records the amount and rate of air you inhale and exhale. It helps diagnose and monitor lung conditions.

47 services47 patients

Test to examine how well the lungs exchange gases 94729

This is a test called a pulmonary function test, which helps understand the efficiency of your lungs. It measures how much air your lungs can hold, how quickly you can move air in and out of your lungs, and how well your lungs put oxygen into and remove carbon dioxide from your blood.

45 services45 patients

Test to measure rate of airflow 94375

This test, known as spirometry, measures how much air you can breathe in and out, and how quickly you can do so. It helps assess your lung function and can be used to diagnose or monitor conditions like asthma or COPD.

32 services32 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.

23 services23 patients

Test to measure expiratory airflow and volume changes before and after medication administration 94060

This procedure measures how air flows in and out of your lungs. It's done before and after medication to see if the treatment improves your breathing. It's a simple, non-invasive test that involves breathing into a device called a spirometer.

12 services12 patients

Hospital Affiliations CMS Care Compare 3

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

Northside Hospital Forsyth

Acute Care Hospitals · Cumming, GA

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number110005

Location1200 Northside Forsyth DriveCumming, GA 30041 · Forsyth County

Birthing friendly

Northside Hospital Cherokee

Acute Care Hospitals · Canton, GA

4/5 CMS rating

OwnershipVoluntary non-profit - Other

CMS Certification Number110008

Location450 Northside Cherokee BoulevardCanton, GA 30115 · Cherokee County

Emergency services Birthing friendly

Northside Hospital

Acute Care Hospitals · Atlanta, GA

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number110161

Location1000 Johnson Ferry Road, NEAtlanta, GA 30342 · Fulton County

Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 30041 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

$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.

84.15/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Individually scored

Quality

68.81

Promoting Interoperability

100

Improvement Activities

Cost

67.81

Reported Quality Measures

Advance Care Plan

99%749 patients4/55-star benchmark: 100%

Breast Cancer Screening

58%253 patients3/55-star benchmark: 100%

Controlling High Blood Pressure

75%268 patients4/55-star benchmark: 98%

e-Prescribing

99%513 patients4/55-star benchmark: 100%

Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention

Patients combinedPopulations: 80% · 379 patients

Patients screened: 83% · 379 patients

73%41 patients3/55-star benchmark: 100%

Provide Patients Electronic Access to Their Health Information

100%362 patients5/55-star benchmark: 100%

Screening for Osteoporosis for Women Aged 65-85 Years of Age

50%290 patients3/55-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.

Referred Medical Equipment & Supplies CMS DME claims 10

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

7 suppliers97 claims97 services$15.09 avg. paid by Medicare

Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell) E0466

DME-Other DME · category DE005N

3 suppliers28 claims28 services$885.91 avg. paid by Medicare

Nebulizer, with compressor E0570

DME-Other DME · category DE000N

4 suppliers71 claims71 services$3.82 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

11 suppliers243 claims243 services$67.63 avg. paid by Medicare

Portable oxygen concentrator, rental E1392

DME-Oxygen and Supplies · category DC002N

4 suppliers58 claims58 services$32.03 avg. paid by Medicare

Formoterol fumarate, inhalation solution, fda approved final product, non-compounded, administered through dme, unit dose form, 20 micrograms J7606

DME-Drugs Administered Through DME · category DG006N

3 suppliers21 claims1,230 services$6.38 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.

JASMINE PATEL NP

Nurse Practitioner (Family)

1505 NORTHSIDE BLVD STE 3500
CUMMING, GA 30041

Forsyth County (770) 292-3120

DR. HISHAM FOZI QUTOB M.D.

Internal Medicine (Pulmonary Disease)

1505 NORTHSIDE BLVD STE 3500
CUMMING, GA 30041

Forsyth County (770) 292-3120

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 Juan Cadavid Sepulveda's NPI number?

The NPI number for Juan Cadavid Sepulveda is 1346455425. It was assigned to this individual provider in the NPPES registry on May 11, 2007.

Where is Juan Cadavid Sepulveda located?

Juan Cadavid Sepulveda practices at 1505 Northside Blvd Ste 3500, Cumming, GA 30041. The listed phone number is (770) 292-3120.

What is Juan Cadavid Sepulveda's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Pulmonary Disease, with taxonomy code 207RP1001X.

Is Juan Cadavid Sepulveda enrolled in Medicare?

Yes. Juan Cadavid Sepulveda 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 Juan Cadavid Sepulveda accept?

Health plans from Ambetter Health, Ambetter from Absolute Total Care, Ambetter of Alabama, Ambetter of North Carolina and Ambetter of Tennessee list Juan Cadavid Sepulveda 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 Juan Cadavid Sepulveda affiliated with any hospitals?

According to CMS data, Juan Cadavid Sepulveda is affiliated with Northside Hospital Forsyth, Northside Hospital Cherokee and Northside Hospital.

When was this NPI record last updated?

The NPPES record for Juan Cadavid Sepulveda was last updated on May 8, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.