JOEL A. HOFFMAN M.D.
NPI 1639178486
Otolaryngology in Cumming, GA

Active since July 14, 2005PECOS EnrolledAccepts Medicare Assignment
4150 DEPUTY BILL CANTRELL MEM ROAD, SUITE 260, CUMMING, GA 30040(470) 297-0289(770) 292-3046 Get Directions Write a Review

NPPES record last updated: September 11, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Sep 11, 2024, May 19, 2021, Feb 26, 2021 and 1 more (4 updates tracked since 2016).

About Joel A. Hoffman M.d. NPPES

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

JOEL A. HOFFMAN M.D. (NPI 1639178486) is an individual otolaryngology provider in Cumming, Georgia, licensed in Georgia (037833) and active in the NPI registry since July 2005. He is enrolled in Medicare PECOS, is affiliated with Northside Hospital Forsyth, and is a graduate of Indiana University School Of Medicine (1987).

NPPES Registry Identity

NPI1639178486
Entity TypeIndividualMale
Primary Taxonomy207Y00000X
Provider Legal NameJOEL A. HOFFMANCredential: M.D.
Location Address4150 DEPUTY BILL CANTRELL MEM ROAD, SUITE 260Cumming, GA 30040
Mailing Address4150 Deputy Bill Cantrell Mem Road, Suite 260Cumming, GA 30040 · (770) 292-3045 · Fax (770) 292-3046
Fax(770) 292-3046
Sole ProprietorNo
Medical School CMSIndiana University School Of MedicineGraduated 1987
Enumeration DateJuly 14, 2005
Last NPPES UpdateSeptember 11, 20244 updates tracked since enumeration
NPPES CertifiedSeptember 11, 2024
NPI 1639178486 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyOtolaryngologyAllopathic & Osteopathic Physicians
Taxonomy Code207Y00000X
License Licensed in GA · 037833
Definition
An otolaryngologist-head and neck surgeon provides comprehensive medical and surgical care for patients with diseases and disorders that affect the ears, nose, throat, the respiratory and upper alimentary systems and related structures of the head and neck. An otolaryngologist diagnoses and provides medical and/or surgical therapy or prevention of diseases, allergies, neoplasms, deformities, disorders and/or injuries of the ears, nose, sinuses, throat, respiratory and upper alimentary systems, face, jaws and the other head and neck systems. Head and neck oncology, facial plastic and reconstructive surgery and the treatment of disorders of hearing and voice are fundamental areas of expertise.
Also ListedSpecialistTaxonomy 174400000X · License 037833 (GA)
4150 DEPUTY BILL CANTRELL MEM ROAD, Cumming, GA 30040

Other Identifiers 6

Other3416408GA · Aetna
Medicaid000580104NGA
Medicaid297069GA
Medicaid10034913GA
Medicaid000580104FGA
Medicaid00580104FGA

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

Joel A. Hoffman 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 ID1557447117
PECOS Enrollment IDI20091214000101
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 12

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 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.
181 services137 patients
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.
61 services52 patients
Removal of impacted ear wax 69210
Impacted ear wax removal is a safe procedure to clear blockages in the ear canal caused by hardened ear wax. A healthcare professional uses specialized tools or a gentle irrigation method to loosen and remove the wax, improving hearing and alleviating discomfort.
57 services42 patients
New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203
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.
53 services53 patients
Diagnostic exam of nasal passages using an endoscope 31231
A diagnostic exam of nasal passages using an endoscope is a non-invasive procedure. A small, flexible tube with a light and camera at the end, called an endoscope, is inserted into the nose. This allows the doctor to view the nasal passages and sinuses, helping to identify any issues.
51 services37 patients
Diagnostic exam of voice box using a flexible endoscope 31575
This procedure involves a doctor examining your voice box using a flexible endoscope, a thin tube with a light and camera. It's inserted through your nose or mouth to visualize your throat area. It helps detect any abnormalities in your voice box, ensuring optimal vocal health.
50 services48 patients

Hospital Affiliations CMS Care Compare 2

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

Northside Hospital Forsyth

Acute Care Hospitals · Cumming, GA
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number110005
Location1200 Northside Forsyth DriveCumming, GA 30041 · Forsyth County
Birthing friendly

Northside Hospital

Acute Care Hospitals · Atlanta, GA
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number110161
Location1000 Johnson Ferry Road, NEAtlanta, GA 30342 · Fulton County
Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 30040 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
$130.64 typical visit price
range $56.84 – $172.43
Typical copayment $32.66 (range $14.21 – $43.10)
Most-billed visit code 99204
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.

Reported Quality Measures

Acute Otitis Externa (AOE): Topical Therapy
Percentage of patients aged 2 years and older with a diagnosis of AOE who were prescribed topical preparations
24%80 patients1/55-star benchmark: 100%
Adult Sinusitis: Antibiotic Prescribed for Acute Viral Sinusitis (Overuse)
Percentage of patients, aged 18 years and older, with a diagnosis of acute viral sinusitis who were prescribed an antibiotic within 10 days after onset of symptoms
Lower rates are better for this measure.
31%91 patients3/55-star benchmark: 100%
Care Plan
Percentage of patients aged 65 years and older who have an advance care plan or surrogate decision maker documented in the medical record that an advance care plan was discussed but the patient did not wish or was not able to name a surrogate decision maker…
8%447 patients1/55-star benchmark: 100%
Documentation of Current Medications in the Medical Record
Percentage of visits for patients aged 18 years and older for which the eligible professional or eligible clinician attests to documenting a list of current medications using all immediate resources available on the date of the encounter.
100%2,076 patients5/55-star benchmark: 100%
e-Prescribing
At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.
55%216 patients2/55-star benchmark: 100%
Health Information Exchange
The MIPS eligible clinician that transitions or refers their patient to another setting of care or health care clinician (1) uses CEHRT to create a summary of care record; and (2) electronically transmits such summary to a receiving health care clinician for…
66%35 patients3/55-star benchmark: 98%
Medication Reconciliation
The MIPS eligible clinician performs medication reconciliation for at least one transition of care in which the patient is transitioned into the care of the MIPS eligible clinician.
98%123 patients4/55-star benchmark: 100%
Pneumococcal Vaccination Status for Older Adults
Percentage of patients 65 years of age and older who have ever received a pneumococcal vaccine
19%447 patients1/55-star benchmark: 95%
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan
Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the previous twelve months AND with a BMI outside of normal parameters, a follow-up plan is documented during the encounter or during the previous…
28%1,238 patients2/55-star benchmark: 100%
Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention
Percentage of patients aged 18 years and older who were screened for tobacco use one or more times within 24 months AND who received tobacco cessation intervention if identified as a tobacco user
10%20 patients1/55-star benchmark: 100%
Provide Patient Access
At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician's discretion to withhold…
92%511 patients4/55-star benchmark: 100%
Secure Messaging
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 CEHRT to the patient (or the patient-authorized representative), or in response to a secure…
82%511 patients5/55-star benchmark: 79%
Sleep Apnea: Assessment of Sleep Symptoms
Percentage of visits for patients aged 18 years and older with a diagnosis of obstructive sleep apnea that includes documentation of an assessment of sleep symptoms, including presence or absence of snoring and daytime sleepiness
18%256 patients1/55-star benchmark: 100%
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.

Referred Medical Equipment & Supplies CMS DME claims 12

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

Tubing with integrated heating element for use with positive airway pressure device A4604
DME-Other DME · category DE001N
11 suppliers52 claims52 services$31.54 avg. paid by Medicare
Full face mask used with positive airway pressure device, each A7030
DME-Other DME · category DE001N
10 suppliers33 claims33 services$73.79 avg. paid by Medicare
Face mask interface, replacement for full face mask, each A7031
DME-Other DME · category DE001N
10 suppliers36 claims88 services$27.44 avg. paid by Medicare
Cushion for use on nasal mask interface, replacement only, each A7032
DME-Other DME · category DE001N
8 suppliers24 claims136 services$16.52 avg. paid by Medicare
Pillow for use on nasal cannula type interface, replacement only, pair A7033
DME-Other DME · category DE001N
4 suppliers15 claims86 services$11.14 avg. paid by Medicare
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap A7034
DME-Other DME · category DE001N
10 suppliers47 claims47 services$48.41 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

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

Hearing Instrument Specialist
4150 DEPUTY BILL CANTRELL MEM ROAD, SUITE 260
CUMMING, GA 30040

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 Joel Hoffman's NPI number?

The NPI number for Joel Hoffman is 1639178486. It was assigned to this individual provider in the NPPES registry on July 14, 2005.

Where is Joel Hoffman located?

Joel Hoffman practices at 4150 Deputy Bill Cantrell Mem Road Suite 260, Cumming, GA 30040. The listed phone number is (470) 297-0289.

What is Joel Hoffman's specialty?

The primary specialty registered for this NPI is Otolaryngology with taxonomy code 207Y00000X.

Is Joel Hoffman enrolled in Medicare?

Yes. Joel Hoffman 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 Joel Hoffman accept?

Health plans from Alliant Health Plans, Inc., Ambetter Health, Ambetter from Absolute Total Care, Ambetter of Alabama and Ambetter of North Carolina and 1 other insurer list Joel Hoffman 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 Joel Hoffman affiliated with any hospitals?

According to CMS data, Joel Hoffman is affiliated with Northside Hospital Forsyth and Northside Hospital.

When was this NPI record last updated?

The NPPES record for Joel Hoffman was last updated on September 11, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 23 months 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.