MALEK MUSHREF M.D.
NPI 1619339124
Internal Medicine - Endocrinology, Diabetes & Metabolism in Athens, GA

Q: What is Malek Mushref's NPI number?

The NPI number for Malek Mushref is 1619339124. It was assigned to this individual provider in the NPPES registry on March 23, 2016.

Q: What is Malek Mushref's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Endocrinology, Diabetes & Metabolism, with taxonomy code 207RE0101X.

Q: When was this NPI record last updated?

The NPPES record for Malek Mushref was last updated on June 18, 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.

Active since March 23, 2016PECOS EnrolledAccepts Medicare Assignment

91.65/100

CMS Quality Rating

1270 PRINCE AVE STE 201, ATHENS, GA 30606(706) 475-7055 Get Directions Write a Review

NPPES record last updated: June 18, 2021. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Jun 18, 2021, Jun 15, 2016, Mar 23, 2016 (3 updates tracked since 2016).

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About Malek Mushref M.d. NPPES

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

MALEK MUSHREF M.D. (NPI 1619339124) is an individual endocrinology, diabetes & metabolism provider in Athens, Georgia, licensed in Georgia (88454) and active in the NPI registry since March 2016. He is enrolled in Medicare PECOS, is affiliated with St Mary's Hospital, and maintains a secondary practice location in Athens.

NPPES Registry Identity

NPI1619339124

Entity TypeIndividualMale

Primary Taxonomy207RE0101X

Provider Legal NameMALEK MUSHREFCredential: M.D.

Location Address1270 PRINCE AVE STE 201Athens, GA 30606-2789

Mailing Address218 Thornhill Dr, Apartment Number 3Athens, GA 30607-1740 · (706) 461-2306

Phone(706) 475-7055

Sole ProprietorNo

Medical School CMSOtherGraduated 2014

Enumeration DateMarch 23, 2016

Last NPPES UpdateJune 18, 20213 updates tracked since enumeration

NPPES CertifiedJune 18, 2021

✔ NPI 1619339124 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal Medicine · Endocrinology, Diabetes & MetabolismAllopathic & Osteopathic Physicians

Taxonomy Code207RE0101X

License✔ Licensed in GA · 88454

Definition

An internist who concentrates on disorders of the internal (endocrine) glands such as the thyroid and adrenal glands. This specialist also deals with disorders such as diabetes, metabolic and nutritional disorders, obesity, pituitary diseases and menstrual and sexual problems.

Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X

1270 PRINCE AVE STE 201, Athens, GA 30606

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Secondary Practice Location 1

Location 11199 Prince AveAthens, GA 30606-2797 · Phone (706) 475-5076 · Fax (706) 475-6676

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Alliant Health Plans, Inc., Ambetter from Absolute Total Care, Ambetter Health and more.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

Malek Mushref 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 ID4587956214

PECOS Enrollment IDI20211006001374

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

Medicare enrollment records show Malek Mushref reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Piedmont Athens Primary Care LLC

0.2 mi

Family Medicine

1199 PRINCE AVE
Athens, GA 30606

Reassigned Medicare billing, Georgia enrollment
118 clinicians in this Medicare group

NPI 1245746783 (706) 369-5440

Piedmont Athens Specialty Care LLC

0.2 mi

Cardiovascular Disease

1199 PRINCE AVE
Athens, GA 30606

Reassigned Medicare billing, Georgia enrollment
140 clinicians in this Medicare group

NPI 1184130627 (706) 475-7000

Piedmont Providers LLC

72 mi

Internal Medicine

220 J L WHITE DR STE 120
Jasper, GA 30143

Reassigned Medicare billing, Georgia enrollment
689 clinicians in this Medicare group

NPI 1548273592 (770) 801-2500

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 7

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.

421 services225 patients

Continuous monitoring of blood sugar level in tissue fluid using sensor under skin with interpretation and report 95251

This procedure involves placing a small sensor under your skin to continuously monitor your blood sugar levels in tissue fluid. The data is interpreted and a report is generated to help manage your diabetes more effectively.

182 services74 patients

Hemoglobin a1c level 83036

Hemoglobin A1c (HbA1c) is a test that measures your average blood sugar level over the past 2-3 months. It's used to monitor how well diabetes is being controlled. High levels may indicate that your diabetes treatment plan needs adjustment.

163 services93 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.

55 services55 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.

31 services29 patients

Ultrasound scan of head and neck soft tissue 76536

An ultrasound scan of the head and neck soft tissue is a non-invasive procedure that uses sound waves to create images of the soft tissues in these areas. It helps identify any abnormalities or issues, such as tumors, cysts, or infections. It's painless and doesn't involve radiation.

17 services17 patients

Hospital Affiliations CMS Care Compare 3

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

St Mary's Hospital

Acute Care Hospitals · Athens, GA

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number110006

Location1230 Baxter StreetAthens, GA 30606 · Clarke County

Emergency services Birthing friendly

Piedmont Walton Hospital

Acute Care Hospitals · Monroe, GA

4/5 CMS rating

OwnershipProprietary

CMS Certification Number110046

Location2151 W Spring StreetMonroe, GA 30655 · Walton County

Emergency services Birthing friendly

Piedmont Athens Regional Medical Center

Acute Care Hospitals · Athens, GA

4/5 CMS rating

OwnershipVoluntary non-profit - Other

CMS Certification Number110074

Location1199 Prince AvenueAthens, GA 30606 · Clarke County

Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 30606 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.

91.65/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored as part of a group practice

Promoting Interoperability

Improvement Activities

Referred Medical Equipment & Supplies CMS DME claims 6

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

Supplies for maintenance of insulin infusion catheter, per week A4224

DME-Other DME · category DE017N

3 suppliers18 claims233 services$18.79 avg. paid by Medicare

Supplies for external insulin infusion pump, syringe type cartridge, sterile, each A4225

DME-Other DME · category DE017N

3 suppliers13 claims390 services$2.39 avg. paid by Medicare

Supply allowance for adjunctive continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service A4238

DME-Medical/Surgical Supplies · category DA000N

2 suppliers12 claims12 services$176.48 avg. paid by Medicare

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253

DME-Other DME · category DE017N

11 suppliers25 claims63 services$6.74 avg. paid by Medicare

External ambulatory infusion pump, insulin E0784

DME-Other DME · category DE017N

1 supplier12 claims12 services$307.25 avg. paid by Medicare

Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service K0553

DME-Other DME · category DE017N

11 suppliers155 claims155 services$181.49 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 20

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

OLUWAMISIMI MARY ABIB MD

Student in an Organized Health Care Education/Training Program