WALTER Z FALCONER M.D.
NPI 1841393188
Urology in Decatur, GA

Active since September 05, 2006PECOS EnrolledAccepts Medicare Assignment
76.25/100
CMS Quality Rating
2685 MILSCOTT DR, DECATUR, GA 30033(404) 292-3727(404) 294-9674 Get Directions Write a Review

NPPES record last updated: March 7, 2023. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Mar 7, 2023, Aug 14, 2020, Mar 1, 2019 (3 updates tracked since 2019).

About Walter Z Falconer M.d. NPPES

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

WALTER Z FALCONER M.D. (NPI 1841393188) is an individual urology provider in Decatur, Georgia, licensed in Georgia (035252) and active in the NPI registry since September 2006. He is enrolled in Medicare PECOS, is affiliated with Emory Decatur Hospital, and is a graduate of University Of Pittsburgh School Of Medicine (1986).

NPPES Registry Identity

NPI1841393188
Entity TypeIndividualMale
Primary Taxonomy208800000X
Provider Legal NameWALTER Z FALCONERCredential: M.D.
Location Address2685 MILSCOTT DRDecatur, GA 30033-5906
Mailing Address1930 Brannan RdMcdonough, GA 30253-4310 · (678) 284-4040 · Fax (678) 284-4076
Fax(404) 294-9674
Sole ProprietorNo
Medical School CMSUniversity Of Pittsburgh School Of MedicineGraduated 1986
Enumeration DateSeptember 5, 2006
Last NPPES UpdateMarch 7, 20233 updates tracked since enumeration
NPPES CertifiedAugust 14, 2020
NPI 1841393188 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyUrologyAllopathic & Osteopathic Physicians
Taxonomy Code208800000X
License Licensed in GA · 035252
Definition
A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures.
2685 MILSCOTT DR, Decatur, GA 30033

Other Identifiers 2

OtherP00046332GA · Railroad Medicare
Medicaid000502851AGA

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

Walter Z Falconer 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 ID3870580160
PECOS Enrollment IDI20050407000711
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 22

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.

Automated urinalysis test 81003
An automated urinalysis test is a routine examination that checks your urine for various substances. It can help identify potential health issues such as kidney problems or diabetes. The test uses a machine to analyze a small urine sample, providing quick and accurate results.
711 services351 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.
618 services326 patients
Psa (prostate specific antigen) measurement, total 84153
PSA measurement is a simple blood test that checks for a specific protein produced by your body. High levels could indicate a health issue that needs further investigation. It's often used to monitor general wellness and is part of routine health screening.
456 services278 patients
Ultrasound measurement of bladder capacity after voiding 51798
Ultrasound measurement of bladder capacity after voiding is a non-invasive test that uses sound waves to create images of your bladder. It's done after you've emptied your bladder to see if there's any leftover urine, which can help diagnose certain conditions.
204 services137 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.
197 services157 patients
Testosterone (hormone) level, total 84403
A total testosterone level test measures the amount of a key hormone in your body. This hormone influences various body functions such as muscle mass, energy levels, and mood. The test involves a simple blood draw, and results help monitor health conditions.
118 services73 patients

Hospital Affiliations CMS Care Compare 5

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

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

Emory University Hospital Midtown

Acute Care Hospitals · Atlanta, GA
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number110078
Location550 Peachtree Street, NEAtlanta, GA 30308 · Fulton County
Emergency services Birthing friendly

Piedmont Rockdale Hospital

Acute Care Hospitals · Conyers, GA
2/5 CMS rating
OwnershipProprietary
CMS Certification Number110091
Location1412 Milstead Avenue, NEConyers, GA 30012 · Rockdale 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

Emory Hillandale Hospital

Acute Care Hospitals · Lithonia, GA
1/5 CMS rating
OwnershipGovernment - Hospital District or Authority
CMS Certification Number110226
Location2801 Dekalb Medical ParkwayLithonia, GA 30058 · De Kalb County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 30033 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.

76.25/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality54.88
Promoting Interoperability97
Improvement Activities40
Cost68.46

Reported Quality Measures

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.
95%3,434 patients4/55-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.
85%388 patients4/55-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…
29%212 patients2/55-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.
95%190 patients4/55-star benchmark: 100%
Patient-Specific Education
The MIPS eligible clinician must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide access to those materials to at least one unique patient seen by the MIPS eligible clinician.
86%843 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
51%1,012 patients3/55-star benchmark: 90%
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…
86%1,720 patients4/55-star benchmark: 97%
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
98%110 patients4/55-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…
58%852 patients3/55-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…
46%852 patients3/55-star benchmark: 79%
Urinary Incontinence: Assessment of Presence or Absence of Urinary Incontinence in Women Aged 65 Years and Older
Percentage of female patients aged 65 years and older who were assessed for the presence or absence of urinary incontinence within 12 months
97%143 patients4/55-star benchmark: 100%
Use of High-Risk Medications in the Elderly
Percentage of patients 65 years of age and older who were ordered high-risk medications. Two rates are submitted. 1) Percentage of patients who were ordered at least one high-risk medication.
Lower rates are better for this measure.
Patients 2+: 0% · 1,012 patients
0%1,012 patients5/55-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 3

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

Male external catheter, with or without adhesive, disposable, each A4349
DME-Medical/Surgical Supplies · category DA000N
1 supplier11 claims455 services$1.66 avg. paid by Medicare
Bedside drainage bag, day or night, with or without anti-reflux device, with or without tube, each A4357
DME-Orthotic Devices · category DF000N
2 suppliers12 claims28 services$7.40 avg. paid by Medicare
Urinary drainage bag, leg or abdomen, vinyl, with or without tube, with straps, each A4358
DME-Orthotic Devices · category DF000N
1 supplier11 claims26 services$5.80 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 12

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

Nurse Practitioner (Acute Care)
2685 MILSCOTT DR
DECATUR, GA 30033
Physician Assistant
2685 MILSCOTT DR
DECATUR, GA 30033
Nurse Practitioner (Acute Care)
2685 MILSCOTT DR
DECATUR, GA 30033
Urology
2685 MILSCOTT DR
DECATUR, GA 30033
Urology
2685 MILSCOTT DR
DECATUR, GA 30033
Urology
2685 MILSCOTT DR
DECATUR, GA 30033
Urology
2685 MILSCOTT DR
DECATUR, GA 30033
Urology
2685 MILSCOTT DR
DECATUR, GA 30033

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 Walter Falconer's NPI number?

The NPI number for Walter Falconer is 1841393188. It was assigned to this individual provider in the NPPES registry on September 5, 2006.

Where is Walter Falconer located?

Walter Falconer practices at 2685 Milscott Dr, Decatur, GA 30033. The listed phone number is (404) 292-3727.

What is Walter Falconer's specialty?

The primary specialty registered for this NPI is Urology with taxonomy code 208800000X.

Is Walter Falconer enrolled in Medicare?

Yes. Walter Falconer 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 Walter Falconer accept?

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

According to CMS data, Walter Falconer is affiliated with Emory Decatur Hospital, Emory University Hospital Midtown, Piedmont Rockdale Hospital, Northside Hospital and Emory Hillandale Hospital.

When was this NPI record last updated?

The NPPES record for Walter Falconer was last updated on March 7, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.