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SUSANA A ALFONSO M.D.
NPI 1487759312
Family Medicine in Atlanta, GA

Active since September 14, 2006PECOS EnrolledAccepts Medicare Assignment
92.26/100
CMS Quality Rating
4500 N SHALLOWFORD RD, ATLANTA, GA 30338(404) 778-6920(404) 778-6901 Get Directions Write a Review

NPPES record last updated: October 8, 2015. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Susana A Alfonso M.d. NPPES

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

SUSANA A ALFONSO M.D. (NPI 1487759312) is an individual family medicine provider in Atlanta, Georgia, licensed in Georgia (46026) and active in the NPI registry since September 2006. She is enrolled in Medicare PECOS, is affiliated with Emory University Hospital, and is a graduate of Medical College Of Georgia School Of Medicine (1996).

NPPES Registry Identity

NPI1487759312
Entity TypeIndividualFemale
Primary Taxonomy207Q00000X
Provider Legal NameSUSANA A ALFONSOCredential: M.D.
Location Address4500 N SHALLOWFORD RDAtlanta, GA 30338-6476
Mailing Address4500 N Shallowford RdAtlanta, GA 30338-6476 · (404) 778-6920 · Fax (404) 778-6901
Phone(404) 778-6920
Fax(404) 778-6901
Sole ProprietorNo
Medical School CMSMedical College Of Georgia School Of MedicineGraduated 1996
Enumeration DateSeptember 14, 2006
Last NPPES UpdateOctober 8, 2015
✔ NPI 1487759312 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in GA · 46026
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
4500 N SHALLOWFORD RD, Atlanta, GA 30338
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Other Identifiers 1

Medicare UPINH46128GA

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Absolute Total Care, Ambetter Health, Ambetter of Alabama 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

Susana A Alfonso 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 ID7911021142
PECOS Enrollment IDI20100825000400
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.

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.
65 services51 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.
38 services36 patients
Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215
This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.
21 services18 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.
20 services20 patients

Hospital Affiliations CMS Care Compare 3

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

Emory University Hospital

Acute Care Hospitals · Atlanta, GA
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number110010
Location1364 Clifton Road, NEAtlanta, GA 30322 · De Kalb County
Emergency services

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

Saint Joseph's Hospital Of Atlanta, Inc

Acute Care Hospitals · Atlanta, GA
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number110082
Location5665 Peachtree Dunwoody RoadAtlanta, GA 30342 · Fulton County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 30338 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
$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 20

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

SOPHIA SNEED MD
Family Medicine
4500 N SHALLOWFORD RD
ATLANTA, GA 30338
Dekalb County (404) 778-6920
TORRANCE CHRISTOPHER LAURY MD
Family Medicine
4500 N SHALLOWFORD RD, SUITE B
DUNWOODY, GA 30338
Dekalb County (404) 778-6920
DR. TERESA LIANNE BECK MD
Family Medicine
4500 N SHALLOWFORD RD
DUNWOODY, GA 30338
Dekalb County (404) 778-6920
DR. ANAGHA CUPPLES DNP, FNP-BC, RN
Nurse Practitioner (Family)
4500 N SHALLOWFORD RD
ATLANTA, GA 30338
Dekalb County (678) 977-0551
DR. NERCIE RENEE DANGER MD
Family Medicine
4500 N SHALLOWFORD RD
DUNWOODY, GA 30338
Dekalb County (678) 849-2936
JAMES KIM JO M.D.
Family Medicine
4500 N SHALLOWFORD RD
ATLANTA, GA 30338
Dekalb County (404) 778-6920
DR. RACHEL MARIE JOHNSON KORNRICH MD
Family Medicine
4500 N SHALLOWFORD RD
ATLANTA, GA 30338
Dekalb County (404) 778-6920
DUNWOODY PHYSICIAN PRACTICE NETWORK INC
Orthopaedic Surgery (Sports Medicine)
4500 N SHALLOWFORD RD, SUITE 500
ATLANTA, GA 30338
Dekalb County (770) 455-4009

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 Susana Alfonso's NPI number?

The NPI number for Susana Alfonso is 1487759312. It was assigned to this individual provider in the NPPES registry on September 14, 2006.

Where is Susana Alfonso located?

Susana Alfonso practices at 4500 N Shallowford Rd, Atlanta, GA 30338. The listed phone number is (404) 778-6920.

What is Susana Alfonso's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Susana Alfonso enrolled in Medicare?

Yes. Susana Alfonso 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 Susana Alfonso accept?

Health plans from Ambetter Health, Ambetter from Absolute Total Care, Ambetter of Alabama, Ambetter of North Carolina and Ambetter of Tennessee list Susana Alfonso 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 Susana Alfonso affiliated with any hospitals?

According to CMS data, Susana Alfonso is affiliated with Emory University Hospital, Emory Decatur Hospital and Saint Joseph's Hospital Of Atlanta, Inc.

When was this NPI record last updated?

The NPPES record for Susana Alfonso was last updated on October 8, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 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.