ANDREW T. MCDONALD M.D.
NPI 1467436600
Hospitalist in Newnan, GA

Active since December 01, 2005PECOS Enrolled
90.8/100
CMS Quality Rating
15 CAVENDER ST, NEWNAN, GA 30263(770) 253-6616(770) 254-6181 Get Directions Write a Review

NPPES record last updated: March 22, 2017. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Andrew T. Mcdonald M.d. NPPES

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

ANDREW T. MCDONALD M.D. (NPI 1467436600) is an individual hospitalist provider in Newnan, Georgia, licensed in Georgia (029211) and active in the NPI registry since December 2005. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1467436600
Entity TypeIndividualMale
Primary Taxonomy208M00000X
Provider Legal NameANDREW T. MCDONALDCredential: M.D.
Location Address15 CAVENDER STNewnan, GA 30263-1931
Mailing Address15 Cavender StNewnan, GA 30263-1931 · (770) 253-6616 · Fax (770) 254-6181
Fax(770) 254-6181
Sole ProprietorNo
Enumeration DateDecember 1, 2005
Last NPPES UpdateMarch 22, 2017
NPI 1467436600 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 · 029211
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 029211 (GA)
15 CAVENDER ST, Newnan, GA 30263

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 (PECOS)

Andrew T. Mcdonald M.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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 6

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.
351 services255 patients
Insertion of needle into vein for collection of blood sample 36415
This procedure involves inserting a small needle into a vein, typically in your arm, to collect a blood sample. It's a quick and simple process to help diagnose or monitor health conditions. You may feel a small prick, but discomfort is minimal.
339 services252 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.
164 services132 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.
45 services22 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.
30 services30 patients
Physician or allowed practitioner certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and G0180
This is a service where a doctor or authorized practitioner certifies that you require Medicare-covered home health services. They will communicate with the home health agency and review reports on your health status to ensure you receive appropriate care. This does not involve an in-person visit.
15 services13 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 30263 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.

90.8/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Promoting Interoperability98
Improvement Activities20

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…
16%543 patients1/55-star benchmark: 100%
Chronic Obstructive Pulmonary Disease (COPD): Spirometry Evaluation
Percentage of patients aged 18 years and older with a diagnosis of COPD who had spirometry results documented
45%51 patients2/55-star benchmark: 100%
Colorectal Cancer Screening
Percentage of adults 50-75 years of age who had appropriate screening for colorectal cancer
62%365 patients3/55-star benchmark: 100%
Diabetes: Eye Exam
Percentage of patients 18-75 years of age with diabetes who had a retinal or dilated eye exam by an eye care professional during the measurement period or a negative retinal exam (no evidence of retinopathy) in the 12 months prior to the measurement period
4%101 patients1/55-star benchmark: 100%
Medication Reconciliation Post-Discharge
The percentage of discharges from any inpatient facility (e.g. hospital, skilled nursing facility, or rehabilitation facility) for patients 18 years and older of age seen within 30 days following discharge in the office by the physician, prescribing…
Patients 65+: 100% · 54 patients
100%59 patients
Pneumococcal Vaccination Status for Older Adults
Percentage of patients 65 years of age and older who have ever received a pneumococcal vaccine
74%556 patients3/55-star benchmark: 100%
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan
Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the previous twelve months AND with a BMI outside of normal parameters, a follow-up plan is documented during the encounter or during the previous…
89%603 patients4/55-star benchmark: 100%
Preventive Care and Screening: Screening for Depression and Follow-Up Plan
Percentage of patients aged 12 years and older screened for depression on the date of the encounter using an age appropriate standardized depression screening tool AND if positive, a follow-up plan is documented on the date of the positive screen
67%500 patients3/55-star benchmark: 100%
Screening for Osteoporosis for Women Aged 65-85 Years of Age
Percentage of female patients aged 65-85 years of age who ever had a central dual-energy X-ray absorptiometry (DXA) to check for osteoporosis
53%227 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 8

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

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253
DME-Other DME · category DE017N
15 suppliers62 claims176 services$6.67 avg. paid by Medicare
Lancets, per box of 100 A4259
DME-Medical/Surgical Supplies · category DA000N
7 suppliers17 claims29 services$1.12 avg. paid by Medicare
Ostomy skin barrier, solid 4 x 4 or equivalent, extended wear, without built-in convexity, each A4385
DME-Orthotic Devices · category DF010N
1 supplier12 claims130 services$4.54 avg. paid by Medicare
Ostomy deodorant, with or without lubricant, for use in ostomy pouch, per fluid ounce A4394
DME-Orthotic Devices · category DF010N
1 supplier12 claims96 services$2.29 avg. paid by Medicare
Ostomy skin barrier, with flange (solid, flexible or accordion), extended wear, without built-in convexity, 4 x 4 inches or smaller, each A4409
DME-Orthotic Devices · category DF010N
1 supplier12 claims120 services$5.50 avg. paid by Medicare
Ostomy pouch, drainable; for use on barrier with non-locking flange, with filter (2 piece system), each A4425
DME-Orthotic Devices · category DF010N
1 supplier12 claims120 services$3.17 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 10

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

Nurse Practitioner (Family)
15 CAVENDER ST
NEWNAN, GA 30263
Internal Medicine
15 CAVENDER ST
NEWNAN, GA 30263
Ophthalmology
15 CAVENDER ST
NEWNAN, GA 30263
Surgery
15 CAVENDER ST
NEWNAN, GA 30263
Internal Medicine (Cardiovascular Disease)
15 CAVENDER ST
NEWNAN, GA 30263
Internal Medicine
15 CAVENDER ST
NEWNAN, GA 30263
Internal Medicine
15 CAVENDER ST
NEWNAN, GA 30263
Internal Medicine
15 CAVENDER ST
NEWNAN, GA 30263

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 Andrew Mcdonald's NPI number?

The NPI number for Andrew Mcdonald is 1467436600. It was assigned to this individual provider in the NPPES registry on December 1, 2005.

Where is Andrew Mcdonald located?

Andrew Mcdonald practices at 15 Cavender St, Newnan, GA 30263. The listed phone number is (770) 253-6616.

What is Andrew Mcdonald's specialty?

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

Is Andrew Mcdonald enrolled in Medicare?

Yes. Andrew Mcdonald is registered in the Medicare PECOS enrollment system.

What insurance does Andrew Mcdonald accept?

Health plans from Alliant Health Plans, Inc. list Andrew Mcdonald 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.

When was this NPI record last updated?

The NPPES record for Andrew Mcdonald was last updated on March 22, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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.