NATHAN LIPSETT MD
NPI 1487628509
Specialist in Stockbridge, GA

NPI Status: Active since February 15, 2006

Contact Information

915 EAGLES LANDING PKWY
STOCKBRIDGE, GA
ZIP 30281
Phone: (770) 996-6699
Fax: (770) 997-4790

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  • Individual
  • Male
  • Specialist
  • Accepts Insurance
  • PECOS Enrolled
  • Medicare Quality Reporting

About NATHAN LIPSETT

This page provides the complete NPI Profile along with additional information for Nathan Lipsett, a provider established in Stockbridge, Georgia with a medical specialization in Specialist. The healthcare provider is registered in the NPI registry with number 1487628509 assigned on February 2006. The practitioner's primary taxonomy code is 174400000X with license number 019718 (GA). The provider is registered as an individual and his NPI record was last updated 4 years ago.

NPI
1487628509
Provider Name
NATHAN LIPSETT MD
Other Name Type
Professional Name (2)
Gender
Male
Entity Type
Individual
Location Address
915 EAGLES LANDING PKWY STOCKBRIDGE, GA 30281
Location Phone
(770) 996-6699
Location Fax
(770) 997-4790
Mailing Address
915 EAGLES LANDING PKWY STOCKBRIDGE, GA 30281
Mailing Phone
(770) 996-6699
Mailing Fax
(770) 997-4790
Is Sole Proprietor?
No
Enumeration Date
02-15-2006
Last Update Date
03-04-2022
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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Specialist

Taxonomy Code
174400000X
Type
Other Service Providers
License No.
019718
License State
GA
Taxonomy Description
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

  • Elite Bronze - HMO
  • Elite Bronze + Vision + Adult Dental - HMO
  • Everyday Bronze - HMO
  • Everyday Bronze + Vision + Adult Dental - HMO
  • Focused Silver - HMO
  • Standard Expanded Bronze - HMO
  • Standard Gold - HMO
  • Standard Silver - HMO
  • Standard Silver + Vision + Adult Dental - HMO
  • Clarity Silver - HMO
  • Complete Gold - HMO
  • Complete Gold + Vision + Adult Dental - HMO
  • Elite Bronze - HMO
  • Elite Bronze + Vision + Adult Dental - HMO
  • Enhanced Diabetes Care Silver with $0 Drug Options - HMO
  • Enhanced Diabetes Care Silver with $0 Drug Options + Vision + Adult Dental - HMO
  • Everyday Bronze - HMO
  • Everyday Bronze + Vision + Adult Dental - HMO
  • Everyday Gold - HMO
  • Complete Gold - EPO
  • Complete Gold + Vision + Adult Dental - EPO
  • Elite Bronze - EPO
  • Elite Bronze + Vision + Adult Dental - EPO
  • Elite Gold - EPO
  • Elite Gold + Vision + Adult Dental - EPO
  • Enhanced Diabetes Care Silver with $0 Drug Options - EPO
  • Enhanced Diabetes Care Silver with $0 Drug Options + Vision + Adult Dental - EPO
  • Everyday Bronze - EPO
  • Everyday Bronze + Vision + Adult Dental - EPO
  • Clear Silver with $0 Insulin Options - HMO
  • Complete Gold - HMO
  • Complete Gold + Vision + Adult Dental - HMO
  • Complete Gold with Atrium Health - HMO
  • Complete Gold with Atrium Health + Vision + Adult Dental - HMO
  • Elite Bronze - HMO
  • Elite Bronze + Vision + Adult Dental - HMO
  • Elite Bronze with Atrium Health - HMO
  • Elite Bronze with Atrium Health + Vision + Adult Dental - HMO
  • Enhanced Asthma/COPD Care Silver with $0 Drug Options - HMO
  • Elite Bronze - EPO
  • Elite Bronze + Vision + Adult Dental - EPO
  • Elite Gold - EPO
  • Elite Gold + Vision + Adult Dental - EPO
  • Enhanced Diabetes Care Silver with $0 Drug Options - EPO
  • Enhanced Diabetes Care Silver with $0 Drug Options + Vision + Adult Dental - EPO
  • Everyday Bronze - EPO
  • Everyday Bronze + Vision + Adult Dental - EPO
  • Everyday Gold - EPO
  • Everyday Gold + Vision + Adult Dental - EPO

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
00178813BMEDICAID (05)GA 

Medicare Participation & PECOS Enrollment Status

Nathan Lipsett is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.

  • Is the provider registered in PECOS? Yes

  • Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes

  • Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes

  • Eligible to Order or Refer a Home Health Agency (HHA): Yes

  • Eligible to Order or Refer Power Mobility Devices: Yes

Provider Referred Orders for Durable Medical Equipment, Devices & Supplies

The following list reflects the services, supplies or durable medical equipment ordered by this provider to a DME supplier on behalf of patients. The information below is derived from Medicare claims data and reflects the BETOS category, HCPCS code information and the number times each service was submitted under the Medicare fee-for-service program.

Durable Medical Equipment

  • DME-Other DME (DE001N)

    Tubing with integrated heating element for use with positive airway pressure device (HCPCS:A4604)

    8 DME suppliers used 78 Medicare Claims 78 Services Paid

  • DME-Other DME (DE000N)

    Administration set, with small volume nonfiltered pneumatic nebulizer, disposable (HCPCS:A7003)

    5 DME suppliers used 21 Medicare Claims 41 Services Paid

  • DME-Other DME (DE000N)

    Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable (HCPCS:A7005)

    8 DME suppliers used 21 Medicare Claims 21 Services Paid

  • DME-Other DME (DE001N)

    Full face mask used with positive airway pressure device, each (HCPCS:A7030)

    6 DME suppliers used 54 Medicare Claims 54 Services Paid

  • DME-Other DME (DE001N)

    Face mask interface, replacement for full face mask, each (HCPCS:A7031)

    5 DME suppliers used 57 Medicare Claims 164 Services Paid

  • DME-Other DME (DE001N)

    Cushion for use on nasal mask interface, replacement only, each (HCPCS:A7032)

    6 DME suppliers used 32 Medicare Claims 183 Services Paid

  • DME-Other DME (DE001N)

    Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap (HCPCS:A7034)

    7 DME suppliers used 39 Medicare Claims 39 Services Paid

  • DME-Other DME (DE001N)

    Headgear used with positive airway pressure device (HCPCS:A7035)

    11 DME suppliers used 52 Medicare Claims 52 Services Paid

  • DME-Other DME (DE001N)

    Filter, disposable, used with positive airway pressure device (HCPCS:A7038)

    11 DME suppliers used 90 Medicare Claims 505 Services Paid

  • DME-Other DME (DE001N)

    Filter, non disposable, used with positive airway pressure device (HCPCS:A7039)

    7 DME suppliers used 21 Medicare Claims 21 Services Paid

  • DME-Other DME (DE001N)

    Water chamber for humidifier, used with positive airway pressure device, replacement, each (HCPCS:A7046)

    8 DME suppliers used 45 Medicare Claims 45 Services Paid

  • DME-Oxygen and Supplies (DC000N)

    Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing (HCPCS:E0431)

    8 DME suppliers used 205 Medicare Claims 219 Services Paid

  • DME-Oxygen and Supplies (DC000N)

    Portable oxygen contents, gaseous, 1 month's supply = 1 unit (HCPCS:E0443)

    3 DME suppliers used 36 Medicare Claims 36 Services Paid

  • DME-Other DME (DE005N)

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

    2 DME suppliers used 36 Medicare Claims 36 Services Paid

  • DME-Other DME (DE000N)

    Nebulizer, with compressor (HCPCS:E0570)

    9 DME suppliers used 115 Medicare Claims 115 Services Paid

  • DME-Oxygen and Supplies (DC002N)

    Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate (HCPCS:E1390)

    13 DME suppliers used 420 Medicare Claims 433 Services Paid

  • DME-Oxygen and Supplies (DC002N)

    Portable oxygen concentrator, rental (HCPCS:E1392)

    7 DME suppliers used 175 Medicare Claims 175 Services Paid

  • DME-Other DME (DE000N)

    Pharmacy dispensing fee for inhalation drug(s); per 30 days (HCPCS:Q0513)

    35 DME suppliers used 230 Medicare Claims 230 Services Paid

Drugs Administered Through DME

  • DME-Drugs Administered Through DME (DG006N)

    Arformoterol, inhalation solution, fda approved final product, non-compounded, administered through dme, unit dose form, 15 micrograms (HCPCS:J7605)

    1 DME suppliers used 38 Medicare Claims 2190 Services Paid

  • DME-Drugs Administered Through DME (DG006N)

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

    3 DME suppliers used 20 Medicare Claims 1320 Services Paid

  • DME-Drugs Administered Through DME (DG006N)

    Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg (HCPCS:J7613)

    25 DME suppliers used 140 Medicare Claims 35462 Services Paid

  • DME-Drugs Administered Through DME (DG006N)

    Albuterol, up to 2.5 mg and ipratropium bromide, up to 0.5 mg, fda-approved final product, non-compounded, administered through dme (HCPCS:J7620)

    19 DME suppliers used 85 Medicare Claims 8000 Services Paid

  • DME-Drugs Administered Through DME (DG000N)

    Budesonide, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, up to 0.5 mg (HCPCS:J7626)

    2 DME suppliers used 31 Medicare Claims 1530 Services Paid

  • DME-Drugs Administered Through DME (DG006N)

    Ipratropium bromide, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, per milligram (HCPCS:J7644)

    3 DME suppliers used 12 Medicare Claims 398 Services Paid

  • DME-Drugs Administered Through DME (DG006N)

    Revefenacin inhalation solution, fda-approved final product, non-compounded, administered through dme, 1 microgram (HCPCS:J7677)

    2 DME suppliers used 30 Medicare Claims 157500 Services Paid

Areas of Expertise

The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.

Established patient office or other outpatient visit, 20-29 minutes

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.

This service was performed 410 times for 272 patients

Established patient office or other outpatient visit, 30-39 minutes

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.

This service was performed 168 times for 129 patients

Injection of drug or substance under skin or into muscle

This procedure involves administering medication directly under the skin or into a muscle. A small needle is used to inject the drug, allowing it to be absorbed quickly into the bloodstream. It's a common method for delivering a variety of medications.

This service was performed 33 times for 20 patients

Injection, methylprednisolone sodium succinate, up to 40 mg

Methylprednisolone sodium succinate is a corticosteroid medication, administered via injection. It helps reduce inflammation and immune responses. It's often used to treat conditions like arthritis, allergies, or skin diseases. The dosage is up to 40 mg.

This service was performed 22 times for 19 patients

New patient office or other outpatient visit, 30-44 minutes

This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.

This service was performed 29 times for 29 patients

New patient office or other outpatient visit, 45-59 minutes

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.

This service was performed 29 times for 29 patients

Test for exercise-induced lung stress

An exercise-induced lung stress test assesses how your lungs respond to physical activity. During the test, you'll exercise on a treadmill or stationary bike while your heart rate, breathing, blood pressure, and oxygen levels are monitored. This helps identify any abnormal lung responses to exercise.

This service was performed 33 times for 30 patients

Test to determine lung volumes using sensors

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.

This service was performed 18 times for 18 patients

Test to examine how well the lungs exchange gases

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.

This service was performed 18 times for 18 patients

Test to measure expiratory airflow and volume

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.

This service was performed 95 times for 90 patients

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

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.

This service was performed 20 times for 20 patients

X-ray of chest, 2 views

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.

This service was performed 98 times for 90 patients

Quality Reporting

The provider participated in CMS Quality Payment Program. The Quality Payment Program aims to improve population health, reduce costs and improve the care received by Medicare beneficiaries. The following quality measures meet Medicare's statistical reporting standards. Not all providers report the same information, because not all providers give the same services to patients. The quality information is just a snapshot of some the care providers give to their patients. Reporting more or less information is not a reflection of quality.

Quality Measure Performance Number of Patients
Annual registration in the Prescription Drug Monitoring ProgramYesN/A
Annual registration by eligible clinician or group in the prescription drug monitoring program of the state where they practice. Activities that simply involve registration are not sufficient. MIPS eligible clinicians and groups must participate for a minimum of 6 months.
e-Prescribing 0% 6264
At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.
Immunization Registry ReportingYesN/A
The MIPS eligible clinician is in active engagement with a public health agency to submit immunization data and receive immunization forecasts and histories from the public health immunization registry/immunization information system (IIS).
Implementation of episodic care management practice improvementsYesN/A
Provide episodic care management, including management across transitions and referrals that could include one or more of the following: Routine and timely follow-up to hospitalizations, ED visits and stays in other institutional settings, including symptom and disease management, and medication reconciliation and management; and/or Managing care intensively through new diagnoses, injuries and exacerbations of illness.
Patient-Specific Education 0% 1893
The MIPS eligible clinician must use clinically relevant information from certified EHR technology to identify patient-specific educational resources and provide electronic access to those materials to at least one unique patient seen by the MIPS eligible clinician.
Provide Patient Access 0% 1893
For at least one unique patient seen by the MIPS eligible clinician: (1) The patient (or the patient authorized representative) is provided timely access to view online, download, and transmit his or her health information; and (2) The MIPS eligible clinician ensures the patient's health information is available for the patient (or patient-authorized representative) to access using any application of their choice that is configured to meet the technical specifications of the Application Programing Interface (API) in the MIPS eligible clinician's certified EHR technology.
Secure Messaging 0% 1893
For at least one unique patient seen by the MIPS eligible clinician during the performance period, a secure message was sent using the electronic messaging function of certified EHR technology to the patient (or the patient-authorized representative), or in response to a secure message sent by the patient (or the patient-authorized representative).
Security Risk AnalysisYesN/A
Conduct or review a security risk analysis in accordance with the requirements in 45 CFR 164.308(a)(1), including addressing the security (to include encryption) of ePHI data created or maintained by certified EHR technology in accordance with requirements in 45 CFR164.312(a)(2)(iv) and 45 CFR 164.306(d)(3), and implement security updates as necessary and correct identified security deficiencies as part of the MIPS eligible clinician's risk management process.

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1487628509, we treat the final digit (9) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 61. The final step is to find the difference between that total and the next multiple of ten (70 - 61 = 9).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
4
Unchanged
Pos 3
8
Doubled → 16 → 1 + 6
Pos 4
7
Unchanged
Pos 5
6
Doubled → 12 → 1 + 2
Pos 6
2
Unchanged
Pos 7
8
Doubled → 16 → 1 + 6
Pos 8
5
Unchanged
Pos 9
0
Doubled → 0
Check
9
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 8 → 16 → 7 6 → 12 → 3 8 → 16 → 7 0 → 0

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 4 + 1 + 6 + 7 + 1 + 2 + 2 + 1 + 6 + 5 + 0 + 24 = 61

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 61 is 70. The difference is the calculated check digit.

70 - 61 = 9
This NPI is valid
The calculated check digit is 9, which matches the last digit of 1487628509.

Other Providers at the Same Location


The following 6 providers are registered at the same or a nearby location.

Specialist
915 EAGLES LANDING PKWY
STOCBRIDGE, GA 30281
Sleep Specialist, PhD
915 EAGLES LANDING PKWY
STOCKBRIDGE, GA 30281
Internal Medicine (Pulmonary Disease)
915 EAGLES LANDING PKWY
STOCKBRIDGE, GA 30281
Internal Medicine (Pulmonary Disease)
915 EAGLES LANDING PKWY
STOCKBRIDGE, GA 30281
Pediatrics
915 EAGLES LANDING PKWY
STOCKBRIDGE, GA 30281
Specialist
915 EAGLES LANDING PKWY
STOCKBRIDGE, GA 30281

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1487628509, enumerated as an "individual" on February 15, 2006.

The provider is located at 915 EAGLES LANDING PKWY STOCKBRIDGE, GA 30281 and the phone number is (770) 996-6699.

Specialist with taxonomy code 174400000X.

The provider might be accepting Accepts: Ambetter from Absolute Total Care, Ambetter. Please consult your insurance carrier or call the provider to verify.