Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 30 days.

DR. ADAM GREGORY DE LA GARZA MD
NPI 1609805522
Ophthalmology in Birmingham, AL

Active since July 02, 2006PECOS EnrolledAccepts Medicare Assignment
94.56/100
CMS Quality Rating
1000 19TH ST S, BIRMINGHAM, AL 35205(205) 930-0700 Get Directions Write a Review

NPPES record last updated: July 10, 2026. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Jul 10, 2026, Jan 30, 2023, Sep 11, 2019 (3 updates tracked since 2019).

About Dr. Adam Gregory De La Garza Md NPPES

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

DR. ADAM GREGORY DE LA GARZA MD (NPI 1609805522) is an individual ophthalmology provider in Birmingham, Alabama, licensed in Alabama (54096) and active in the NPI registry since July 2006. He is enrolled in Medicare PECOS, is affiliated with Emory University Hospital, and maintains a secondary practice location in Atlanta.

NPPES Registry Identity

NPI1609805522
Entity TypeIndividualMale
Primary Taxonomy207W00000X
Provider Legal NameDR. ADAM GREGORY DE LA GARZACredential: MD
Location Address1000 19TH ST SBirmingham, AL 35205-4804
Mailing Address1365b Clifton Rd NeAtlanta, GA 30322-1013 · (404) 778-2020 · Fax (404) 778-4415
Sole ProprietorNo
Medical School CMSWake Forest University School Of MedicineGraduated 2002
Enumeration DateJuly 2, 2006
Last NPPES UpdateJuly 10, 20263 updates tracked since enumeration
NPPES CertifiedJuly 10, 2026
NPI 1609805522 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyOphthalmologyAllopathic & Osteopathic Physicians
Taxonomy Code207W00000X
Licenses Licensed in AL · 54096 Licensed in OK · 26270 Licensed in IA · 36592 Licensed in GA · 081784
Definition

An ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual disorders. This includes problems affecting the eye and its component structures, the eyelids, the orbit and the visual pathways. In so doing, an ophthalmologist prescribes vision services, including glasses and contact lenses.

Also ListedOphthalmology · Ophthalmic Plastic and Reconstructive SurgeryTaxonomy 207WX0200X · License 081784 (GA)
1000 19TH ST S, Birmingham, AL 35205

Secondary Practice Location 1

Location 11365B Clifton Rd NEAtlanta, GA 30322-4003 · Phone (404) 778-2020

Other Identifiers 3

Medicaid0727560IA
Medicaid200197860AOK
Other25275IA · Wellmark Bcbs

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 and accepts Medicare assignment

Dr. Adam Gregory De La Garza 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 ID2264436492
PECOS Enrollment IDI20190415000582
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 8

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.
73 services67 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.
47 services36 patients
Exam of visual field with limited testing 92081
An exam of the visual field with limited testing is a quick check of your peripheral vision. It involves identifying objects or movements at the edge of your sight, helping to detect any vision loss that isn't obvious, such as blind spots or areas of reduced vision.
35 services34 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.
30 services29 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.
20 services20 patients
Removal of excessive skin and fat of upper eyelid 15823
This procedure, also known as upper eyelid surgery, is performed to remove excess skin and fat from the upper eyelid. It can help improve vision if heavy eyelids hinder it, and can also enhance the appearance of the eyes. It's a common, safe procedure.
17 services17 patients

Hospital Affiliations CMS Care Compare 2

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

Grady Memorial Hospital

Acute Care Hospitals · Atlanta, GA
1/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number110079
Location80 Jesse Hill, Jr Drive SEAtlanta, GA 30303 · Fulton County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 35205 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
$122.31 typical visit price
range $52.65 – $161.63
Typical copayment $30.57 (range $13.16 – $40.40)
Most-billed visit code 99204
Established Patient
$66.08 typical visit price
range $16.56 – $131.65
Typical copayment $16.52 (range $4.14 – $32.91)
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.

94.56/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality78.49
Promoting Interoperability100
Improvement Activities40
Cost75.54

Other Providers at the Same Location NPPES 12

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

Ophthalmology
1000 19TH ST S
BIRMINGHAM, AL 35205
Ophthalmology
1000 19TH ST S
BIRMINGHAM, AL 35205
Ophthalmology (Ophthalmic Plastic and Reconstructive Surgery)
1000 19TH ST S
BIRMINGHAM, AL 35205
Ophthalmology (Ophthalmic Plastic and Reconstructive Surgery)
1000 19TH ST S
BIRMINGHAM, AL 35205
Ophthalmology
1000 19TH ST S
BIRMINGHAM, AL 35205
Ophthalmology (Pediatric Ophthalmology and Strabismus Specialist)
1000 19TH ST S
BIRMINGHAM, AL 35205
Ophthalmology
1000 19TH ST S
BIRMINGHAM, AL 35205
Ophthalmology (Pediatric Ophthalmology and Strabismus Specialist)
1000 19TH ST S
BIRMINGHAM, AL 35205

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 Adam De La Garza's NPI number?

The NPI number for Adam De La Garza is 1609805522. It was assigned to this individual provider in the NPPES registry on July 2, 2006.

Where is Adam De La Garza located?

Adam De La Garza practices at 1000 19th St S, Birmingham, AL 35205. The listed phone number is (205) 930-0700.

What is Adam De La Garza's specialty?

The primary specialty registered for this NPI is Ophthalmology with taxonomy code 207W00000X.

Is Adam De La Garza enrolled in Medicare?

Yes. Adam De La Garza 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 Adam De La Garza accept?

Health plans from Ambetter Health, Ambetter from Absolute Total Care, Ambetter of Alabama, Ambetter of North Carolina and Ambetter of Tennessee list Adam De La Garza 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 Adam De La Garza affiliated with any hospitals?

According to CMS data, Adam De La Garza is affiliated with Emory University Hospital and Grady Memorial Hospital.

When was this NPI record last updated?

The NPPES record for Adam De La Garza was last updated on July 10, 2026. NPI Profile syncs with the weekly NPPES data releases published by CMS.