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DR. LAROY PETE PENIX M.D.
NPI 1396837225
Psychiatry & Neurology - Neurology in East Point, GA

Active since September 28, 2006PECOS EnrolledAccepts Medicare Assignment
92.26/100
CMS Quality Rating
1100 CLEVELAND AVE, SUITE 100, EAST POINT, GA 30344(404) 766-4760(404) 766-4702 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Dr. Laroy Pete Penix M.d. NPPES

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

DR. LAROY PETE PENIX M.D. (NPI 1396837225) is an individual neurology provider in East Point, Georgia, licensed in Georgia (49080) and active in the NPI registry since September 2006. He is enrolled in Medicare PECOS, is affiliated with Emory Decatur Hospital, and is a graduate of Johns Hopkins University School Of Medicine (1984).

NPPES Registry Identity

NPI1396837225
Entity TypeIndividualMale
Primary Taxonomy2084N0400X
Provider Legal NameDR. LAROY PETE PENIXCredential: M.D.
Location Address1100 CLEVELAND AVE, SUITE 100East Point, GA 30344-3602
Mailing Address1667 Niskey Lake Rd SwAtlanta, GA 30331-6401 · (404) 344-3142 · Fax (404) 344-9263
Phone(404) 766-4760
Fax(404) 766-4702
Sole ProprietorYes
Medical School CMSJohns Hopkins University School Of MedicineGraduated 1984
Enumeration DateSeptember 28, 2006
Last NPPES UpdateJuly 8, 2007
✔ NPI 1396837225 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychiatry & Neurology · NeurologyAllopathic & Osteopathic Physicians
Taxonomy Code2084N0400X
License✔ Licensed in GA · 49080
Definition
A Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures.
1100 CLEVELAND AVE, East Point, GA 30344
Open in Google Maps ↗

Other Identifiers 3

Medicare UPINF29736GA
Medicare ID-Type Unspecified11BDSHKGA
Medicaid00886894AGA

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. Laroy Pete Penix 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 ID2860489192
PECOS Enrollment IDI20040429000329
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 4

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.
69 services50 patients
Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes 99222
Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.
59 services58 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.
15 services15 patients
Emergency department visit with moderate level of medical decision making 99284
An emergency department visit for a high-severity issue means you're experiencing a serious health problem that needs immediate attention. This could be a severe injury, serious illness, or life-threatening condition. Medical professionals will provide urgent care to stabilize your condition.
13 services13 patients

Hospital Affiliations CMS Care Compare 2

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

Emory Decatur Hospital

Acute Care Hospitals · Decatur, GA
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number110076
Location2701 N Decatur RoadDecatur, GA 30033 · De Kalb County
Emergency services Birthing friendly

Emory Hillandale Hospital

Acute Care Hospitals · Lithonia, GA
1/5 CMS rating
OwnershipGovernment - Hospital District or Authority
CMS Certification Number110226
Location2801 Dekalb Medical ParkwayLithonia, GA 30058 · De Kalb County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 30344 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.

92.26/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality73.83
Promoting Interoperability100
Improvement Activities40

Other Providers at the Same Location NPPES 5

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

DR. LETISHA EDWARDS DDS
Dentist
1100 CLEVELAND AVE
EAST POINT, GA 30344
Fulton County (404) 564-6776
LARESHA FOSTER M.A., L.M.S.W., CAMS
Counselor (Mental Health)
1100 CLEVELAND AVE
EAST POINT, GA 30344
Fulton County (404) 564-7063
SOUTHSIDE MEDICAL CENTER, INC.
Community/Behavioral Health
1100 CLEVELAND AVE
ATLANTA, GA 30344
Fulton County (404) 627-1385
MS. EILEEN NEIZER NP-C
Nurse Practitioner (Family)
1100 CLEVELAND AVE
EAST POINT, GA 30344
Fulton County (404) 564-6778
CAMILLE MOWATT
Physician Assistant (Medical)
1100 CLEVELAND AVE
EAST POINT, GA 30344
Fulton County (404) 564-6784

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 Laroy Penix's NPI number?

The NPI number for Laroy Penix is 1396837225. It was assigned to this individual provider in the NPPES registry on September 28, 2006.

Where is Laroy Penix located?

Laroy Penix practices at 1100 Cleveland Ave Suite 100, East Point, GA 30344. The listed phone number is (404) 766-4760.

What is Laroy Penix's specialty?

The primary specialty registered for this NPI is Psychiatry & Neurology, specializing in Neurology, with taxonomy code 2084N0400X.

Is Laroy Penix enrolled in Medicare?

Yes. Laroy Penix 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 Laroy Penix 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 Laroy Penix 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 Laroy Penix affiliated with any hospitals?

According to CMS data, Laroy Penix is affiliated with Emory Decatur Hospital and Emory Hillandale Hospital.

When was this NPI record last updated?

The NPPES record for Laroy Penix was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 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.