JUSTIN DEREK CAUGHRON MD
NPI 1477711919
Radiology - Vascular & Interventional Radiology in Lawrenceville, GA

Active since May 31, 2008PECOS EnrolledAccepts Medicare Assignment
95.75/100
CMS Quality Rating
1000 MEDICAL CENTER BLVD, LAWRENCEVILLE, GA 30046(678) 312-4440 Get Directions Write a Review

NPPES record last updated: May 27, 2021. Verified against the NPPES registry weekly; last sync: November 08, 2026.

Record update history: May 27, 2021, Mar 11, 2021 (2 updates tracked since 2021).

About Justin Derek Caughron Md NPPES

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

JUSTIN DEREK CAUGHRON MD (NPI 1477711919) is an individual vascular & interventional radiology provider in Lawrenceville, Georgia, licensed in Georgia (68491) and active in the NPI registry since May 2008. He is enrolled in Medicare PECOS, is affiliated with Adventhealth Orlando, and is a graduate of University Of Tennessee, Hsc, College Of Medicine (2007).

NPPES Registry Identity

NPI1477711919
Entity TypeIndividualMale
Primary Taxonomy2085R0204X
Provider Legal NameJUSTIN DEREK CAUGHRONCredential: MD
Location Address1000 MEDICAL CENTER BLVDLawrenceville, GA 30046-7694
Mailing AddressPo Box 1746Indianapolis, IN 46206-1746 · (855) 206-4923
Sole ProprietorNo
Medical School CMSUniversity Of Tennessee, Hsc, College Of MedicineGraduated 2007
Enumeration DateMay 31, 2008
Last NPPES UpdateMay 27, 20212 updates tracked since enumeration
NPPES CertifiedMay 27, 2021
✔ NPI 1477711919 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyRadiology · Vascular & Interventional RadiologyAllopathic & Osteopathic Physicians
Taxonomy Code2085R0204X
License✔ Licensed in GA · 68491
Definition
A radiologist who diagnoses and treats diseases by various radiologic imaging modalities. These include fluoroscopy, digital radiography, computed tomography, sonography and magnetic resonance imaging.
Also ListedRadiology · Diagnostic RadiologyTaxonomy 2085R0202X · License N2024 (TX), 068491 (GA)
1000 MEDICAL CENTER BLVD, Lawrenceville, GA 30046

Other Identifiers 1

Medicaid003153633GA

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Justin Derek Caughron 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 ID7618136110
PECOS Enrollment IDI20120301000619, I20150220002395, I20241127003938
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.

Medicare Billing Reassignments

9

Medicare enrollment records show Justin Caughron reassigns Medicare billing to 9 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Diagnostic Radiology
1000 MEDICAL CENTER BLVD
Lawrenceville, GA 30045
  • Reassigned Medicare billing, Georgia enrollment
  • 43 clinicians in this Medicare group
Diagnostic Radiology
960 RINEHART RD STE 1000
Lake Mary, FL 32746
  • Reassigned Medicare billing, Florida and Georgia enrollments
  • 433 clinicians in this Medicare group
Diagnostic Radiology
601 E ROLLINS STREET
Orlando, FL 32803
  • Reassigned Medicare billing, Florida and Georgia enrollments
  • 428 clinicians in this Medicare group
Diagnostic Radiology
14302 BRUCE B DOWNS BLVD
Tampa, FL 33613
  • Reassigned Medicare billing, Georgia enrollment
  • 16 clinicians in this Medicare group
Hematology & Oncology
3100 PLAZA PROPERTIES BLVD
Columbus, OH 43219
  • Reassigned Medicare billing, Texas enrollment
  • 75 clinicians in this Medicare group
Diagnostic Radiology
7180 N UNIVERSITY DR
Tamarac, FL 33321
  • Reassigned Medicare billing, Florida enrollment
  • 84 clinicians in this Medicare group
Hematology & Oncology
1920 COUNTRY PLACE PKWY, SUITE 370
Pearland, TX 77584
  • Reassigned Medicare billing, Texas enrollment
  • 58 clinicians in this Medicare group
Diagnostic Radiology
1346 CAMPBELL RD
Houston, TX 77055
  • Reassigned Medicare billing, Texas enrollment
  • 169 clinicians in this Medicare group
Diagnostic Radiology
6740 E CAMELBACK RD STE 100
Scottsdale, AZ 85251
  • Reassigned Medicare billing, Georgia enrollment
  • 13 clinicians in this Medicare group

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 102

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.

Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml Q9967
Low osmolar contrast material with 300-399 mg/ml iodine concentration is a diagnostic tool used in imaging procedures. It helps to enhance the visibility of specific areas in the body, aiding in accurate diagnosis. It's safe and generally well-tolerated by patients.
1,600 services35 patients
Ct scan of chest without contrast 71250
A CT scan of the chest without contrast is a non-invasive imaging procedure. It uses special X-ray equipment to produce detailed images of your chest area, including your lungs and heart. It can help diagnose conditions such as lung diseases or heart disorders. It doesn't involve any dyes or contrast agents.
1,023 services1,007 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.
349 services347 patients
X-ray of chest, 1 view 71045
A chest X-ray, 1 view, is a quick, painless test that produces images of the structures within your chest, such as your heart, lungs, and blood vessels. It helps in diagnosing conditions like pneumonia, heart problems, or lung cancer. You'll stand in front of a machine that emits X-rays, which pass through your body to create the image.
320 services293 patients
Ct scan of abdomen and pelvis with contrast 74177
A CT scan of the abdomen and pelvis with contrast is an imaging procedure. A special dye, called contrast, is used to make certain areas more visible. This can help identify issues such as infections, tumors, or other abnormalities. The procedure is painless and usually takes about 30 minutes.
284 services274 patients
Ct scan of abdomen and pelvis without contrast 74176
A CT scan of the abdomen and pelvis is a non-invasive medical test. It uses special X-ray equipment to create detailed images of your abdominal and pelvic areas. This helps doctors examine organs, tissues, and vessels. No contrast dye is used in this procedure.
261 services259 patients

Hospital Affiliations CMS Care Compare 5

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

Adventhealth Orlando

Acute Care Hospitals · Orlando, FL
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number100007
Location601 E Rollins StOrlando, FL 32803 · Orange County
Emergency services Birthing friendly

Adventhealth Waterman

Acute Care Hospitals · Tavares, FL
4/5 CMS rating
OwnershipVoluntary non-profit - Church
CMS Certification Number100057
Location1000 Waterman WayTavares, FL 32778 · Lake County
Birthing friendly

Adventhealth Daytona Beach

Acute Care Hospitals · Daytona Beach, FL
5/5 CMS rating
OwnershipVoluntary non-profit - Church
CMS Certification Number100068
Location301 Memorial Medical ParkwayDaytona Beach, FL 32117 · Volusia County
Emergency services Birthing friendly

Northside Hospital Gwinnett

Acute Care Hospitals · Lawrenceville, GA
2/5 CMS rating
OwnershipGovernment - Hospital District or Authority
CMS Certification Number110087
Location1000 Medical Center BoulevardLawrenceville, GA 30046 · Gwinnett County
Birthing friendly

Northside Hospital Duluth

Acute Care Hospitals · Duluth, GA
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number110252
Location3620 Howell Ferry RoadDuluth, GA 30096 · Gwinnett County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 30046 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
$88.06 typical visit price
range $56.84 – $172.43
Typical copayment $22.01 (range $14.21 – $43.10)
Most-billed visit code 99203
Established Patient
$70.85 typical visit price
range $18.22 – $140.40
Typical copayment $17.71 (range $4.55 – $35.10)
Most-billed visit code 99213
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.

95.75/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality95
Improvement Activities40

Reported Quality Measures

Appropriate Follow-up Imaging for Incidental Abdominal Lesions
Percentage of final reports for abdominal imaging studies for asymptomatic patients aged 18 years and older with one or more of the following noted incidentally with follow_up imaging recommended: - Liver lesion =< 0.5 cm - Cystic kidney lesion < 1.0 cm -…
Lower rates are better for this measure.
0%75 patients
Radiation Consideration for Adult CT: Utilization of Dose Lowering Techniques
Percentage of final reports for patients aged 18 years and older undergoing CT with documentation that one or more of the following dose reduction techniques were used: - Automated exposure control - Adjustment of the mA and/or kV according to patient size -…
100%669 patients
Radiology: Stenosis Measurement in Carotid Imaging Reports
Percentage of final reports for carotid imaging studies (neck magnetic resonance angiography [MRA], neck computed tomography angiography [CTA], neck duplex ultrasound, carotid angiogram) performed that include direct or indirect reference to measurements of…
100%66 patients
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.

Other Providers at the Same Location NPPES 20

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

Anesthesiology
1000 MEDICAL CENTER BLVD
LAWRENCEVILLE, GA 30046
Anesthesiologist Assistant
1000 MEDICAL CENTER BLVD
LAWRENCEVILLE, GA 30046
Anesthesiologist Assistant
1000 MEDICAL CENTER BLVD
LAWRENCEVILLE, GA 30046
Physician Assistant
1000 MEDICAL CENTER BLVD
LAWRENCEVILLE, GA 30046
Nurse Practitioner (Psychiatric/Mental Health)
1000 MEDICAL CENTER BLVD
LAWRENCEVILLE, GA 30046
Nurse Practitioner (Family)
1000 MEDICAL CENTER BLVD
LAWRENCEVILLE, GA 30046
Anesthesiologist Assistant
1000 MEDICAL CENTER BLVD
LAWRENCEVILLE, GA 30046
Physician Assistant
1000 MEDICAL CENTER BLVD
LAWRENCEVILLE, GA 30046

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 Justin Caughron's NPI number?

The NPI number for Justin Caughron is 1477711919. It was assigned to this individual provider in the NPPES registry on May 31, 2008.

Where is Justin Caughron located?

Justin Caughron practices at 1000 Medical Center Blvd, Lawrenceville, GA 30046. The listed phone number is (678) 312-4440.

What is Justin Caughron's specialty?

The primary specialty registered for this NPI is Radiology, specializing in Vascular & Interventional Radiology, with taxonomy code 2085R0204X.

Is Justin Caughron enrolled in Medicare?

Yes. Justin Caughron 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.

Which organizations bill Medicare for Justin Caughron's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Justin Caughron reassigns Medicare benefits to 9 organizations: North Metropolitan Radiology Associates, LLP (Lawrenceville, GA), Florida Radiology Imaging At Lake Mary, LLC (Lake Mary, FL), Florida Hospital Medical Group Inc (Orlando, FL), Simonmed Imaging Florida LLC (Tampa, FL), American Oncology Partners PA (Columbus, OH) and 4 more organizations, listed in the Medicare section above. Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Justin Caughron's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Justin Caughron accept?

Health plans from Ambetter Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter from Superior HealthPlan and Ambetter of Oklahoma and 6 other insurers list Justin Caughron 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 Justin Caughron affiliated with any hospitals?

According to CMS data, Justin Caughron is affiliated with Adventhealth Orlando, Adventhealth Waterman, Adventhealth Daytona Beach, Northside Hospital Gwinnett and Northside Hospital Duluth.

When was this NPI record last updated?

The NPPES record for Justin Caughron was last updated on May 27, 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.