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DR. JOHN PAUL PAPADOPOULOS M.D.
NPI 1376074666
Internal Medicine in Athens, GA

Active since March 27, 2017PECOS EnrolledAccepts Medicare Assignment
100/100
CMS Quality Rating
1270 PRINCE AVE # 70, ATHENS, GA 30606(706) 475-7055 Get Directions Write a Review

NPPES record last updated: July 22, 2020. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Jul 22, 2020, Jul 15, 2020, Jun 24, 2020 and 1 more (4 updates tracked since 2017).

About Dr. John Paul Papadopoulos M.d. NPPES

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

DR. JOHN PAUL PAPADOPOULOS M.D. (NPI 1376074666) is an individual internal medicine provider in Athens, Georgia, licensed in Georgia (85702) and active in the NPI registry since March 2017. He is enrolled in Medicare PECOS, is affiliated with St Mary's Hospital, and is a graduate of Other (2015).

NPPES Registry Identity

NPI1376074666
Entity TypeIndividualMale
Primary Taxonomy207R00000X
Provider Legal NameDR. JOHN PAUL PAPADOPOULOSCredential: M.D.
Location Address1270 PRINCE AVE # 70Athens, GA 30606-2762
Mailing Address1199 Prince Ave # 70Athens, GA 30606-2797
Phone(706) 475-7055
Sole ProprietorNo
Medical School CMSOtherGraduated 2015
Enumeration DateMarch 27, 2017
Last NPPES UpdateJuly 22, 20204 updates tracked since enumeration
NPPES CertifiedJuly 22, 2020
✔ NPI 1376074666 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 GA · 85702
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 ListedHospitalistTaxonomy 208M00000X · License 85702 (GA)
1270 PRINCE AVE # 70, Athens, GA 30606
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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

Dr. John Paul Papadopoulos 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 ID42634776
PECOS Enrollment IDI20200728000805
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.

Critical care, first 30-74 minutes 99291
Critical care involves immediate and constant attention by a team of specially-trained health professionals. It's for patients with life-threatening conditions, requiring first 30-74 minutes of intense monitoring and treatment.
458 services174 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.
60 services50 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.
34 services29 patients
Critical care, each additional 30 minutes 99292
Critical care refers to special attention given to patients facing life-threatening conditions. Each additional 30 minutes indicates the extension of this specialized care. This might include close monitoring, medication adjustments, and immediate interventions as needed.
23 services17 patients
Insertion of artery tube for blood sampling or infusion through skin 36620
This procedure involves placing a small tube into an artery, usually in the wrist or elbow, to collect blood samples or administer medication. It's done under local anesthesia and is a common, safe practice.
17 services16 patients
Insertion of non-tunneled central venous tube for infusion (5 years or older) 36556
This procedure involves placing a thin tube into a large vein, usually in the neck or chest, to administer medication or fluids. It's done under local anesthesia to minimize discomfort. It's a standard, safe procedure for individuals aged 5 and above.
15 services15 patients

Hospital Affiliations CMS Care Compare 3

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

St Mary's Hospital

Acute Care Hospitals · Athens, GA
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number110006
Location1230 Baxter StreetAthens, GA 30606 · Clarke County
Emergency services Birthing friendly

Piedmont Walton Hospital

Acute Care Hospitals · Monroe, GA
4/5 CMS rating
OwnershipProprietary
CMS Certification Number110046
Location2151 W Spring StreetMonroe, GA 30655 · Walton 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.

100/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Promoting Interoperability99
Improvement Activities40

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.

KABIN SAPKOTA MD
Student in an Organized Health Care Education/Training Program
1270 PRINCE AVE # 70
ATHENS, GA 30606
Clarke County (706) 475-7055
BHAVNA BALI
Internal Medicine (Addiction Medicine)
1270 PRINCE AVE # 70
ATHENS, GA 30606
Clarke County (706) 475-7055

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 John Papadopoulos's NPI number?

The NPI number for John Papadopoulos is 1376074666. It was assigned to this individual provider in the NPPES registry on March 27, 2017.

Where is John Papadopoulos located?

John Papadopoulos practices at 1270 Prince Ave # 70, Athens, GA 30606. The listed phone number is (706) 475-7055.

What is John Papadopoulos's specialty?

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

Is John Papadopoulos enrolled in Medicare?

Yes. John Papadopoulos 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 John Papadopoulos 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 John Papadopoulos 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 John Papadopoulos affiliated with any hospitals?

According to CMS data, John Papadopoulos is affiliated with St Mary's Hospital, Piedmont Walton Hospital and Piedmont Athens Regional Medical Center.

When was this NPI record last updated?

The NPPES record for John Papadopoulos was last updated on July 22, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.