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EDWARD ANTONIO ESPINOSA MD
NPI 1851597397
Internal Medicine in Atlanta, GA

Active since June 22, 2007PECOS EnrolledAccepts Medicare Assignment
98.31/100
CMS Quality Rating
91 W WIEUCA RD NE STE 1000, ATLANTA, GA 30342(404) 257-5585(404) 257-9985 Get Directions Write a Review

NPPES record last updated: March 6, 2018. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Mar 6, 2018, Jan 19, 2017 (2 updates tracked since 2017).

About Edward Antonio Espinosa Md NPPES

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

EDWARD ANTONIO ESPINOSA MD (NPI 1851597397) is an individual internal medicine provider in Atlanta, Georgia, licensed in Georgia (059636) and active in the NPI registry since June 2007. He is enrolled in Medicare PECOS, is affiliated with Northside Hospital Cherokee, and is a graduate of New York College Of Osteo Medicine Of New York Institute Of Technology (2004).

NPPES Registry Identity

NPI1851597397
Entity TypeIndividualMale
Primary Taxonomy207R00000X
Provider Legal NameEDWARD ANTONIO ESPINOSACredential: MD
Location Address91 W WIEUCA RD NE STE 1000Atlanta, GA 30342-3289
Mailing Address91 W Wieuca Rd Ne Ste 1000Atlanta, GA 30342-3289 · (404) 257-5585 · Fax (404) 257-9985
Phone(404) 257-5585
Fax(404) 257-9985
Sole ProprietorYes
Medical School CMSNew York College Of Osteo Medicine Of New York Institute Of TechnologyGraduated 2004
Enumeration DateJune 22, 2007
Last NPPES UpdateMarch 6, 20182 updates tracked since enumeration
✔ NPI 1851597397 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License✔ Licensed in GA · 059636
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
91 W WIEUCA RD NE STE 1000, Atlanta, GA 30342
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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

Edward Antonio Espinosa 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 ID2264523166
PECOS Enrollment IDI20070807000529
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.

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232
Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.
138 services83 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.
124 services63 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.
109 services66 patients
Insertion of needle into vein for collection of blood sample 36415
This procedure involves inserting a small needle into a vein, typically in your arm, to collect a blood sample. It's a quick and simple process to help diagnose or monitor health conditions. You may feel a small prick, but discomfort is minimal.
79 services59 patients
Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes 99233
Follow-up hospital inpatient care per day typically involves a 35-minute check-up by your healthcare provider. This service includes monitoring your health progress, adjusting your treatment plan if needed, and answering any questions you may have about your condition or care.
53 services39 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.
43 services43 patients

Hospital Affiliations CMS Care Compare 3

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

Northside Hospital Cherokee

Acute Care Hospitals · Canton, GA
4/5 CMS rating
OwnershipVoluntary non-profit - Other
CMS Certification Number110008
Location450 Northside Cherokee BoulevardCanton, GA 30115 · Cherokee County
Emergency services Birthing friendly

Piedmont Hospital

Acute Care Hospitals · Atlanta, GA
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number110083
Location1968 Peachtree Rd NWAtlanta, GA 30309 · Fulton County
Emergency services 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 30342 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
$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.

98.31/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality97.88
Improvement Activities40
Cost84.56

Other Providers at the Same Location NPPES 3

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

VALERIE PERSHAD MD
Internal Medicine
91 W WIEUCA RD NE STE 1000
ATLANTA, GA 30342
Fulton County (404) 257-5585
WELLCOMEMD BUCKHEAD, LLC
Internal Medicine
91 W WIEUCA RD NE STE 1000
ATLANTA, GA 30342
Fulton County (404) 257-5585
OPTUMMD LLC
Internal Medicine
91 W WIEUCA RD NE STE 1000
ATLANTA, GA 30342
Fulton County (404) 257-5585

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 Edward Espinosa's NPI number?

The NPI number for Edward Espinosa is 1851597397. It was assigned to this individual provider in the NPPES registry on June 22, 2007.

Where is Edward Espinosa located?

Edward Espinosa practices at 91 W Wieuca Rd NE Ste 1000, Atlanta, GA 30342. The listed phone number is (404) 257-5585.

What is Edward Espinosa's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Edward Espinosa enrolled in Medicare?

Yes. Edward Espinosa 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 Edward Espinosa accept?

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

According to CMS data, Edward Espinosa is affiliated with Northside Hospital Cherokee, Piedmont Hospital and Northside Hospital.

When was this NPI record last updated?

The NPPES record for Edward Espinosa was last updated on March 6, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 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.