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GERALD E CRITES MD
NPI 1861458630
Internal Medicine in Athens, GA

Active since April 21, 2006PECOS EnrolledAccepts Medicare Assignment
72.81/100
CMS Quality Rating
1500 OGLETHORPE AVE STE 200C, ATHENS, GA 30606(706) 389-3875(706) 389-3876 Get Directions Write a Review

NPPES record last updated: March 4, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Mar 4, 2026, Oct 25, 2022, May 11, 2021 (3 updates tracked since 2021).

About Gerald E Crites Md NPPES

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

GERALD E CRITES MD (NPI 1861458630) is an individual internal medicine provider in Athens, Georgia, licensed in Georgia (63311) and active in the NPI registry since April 2006. He is enrolled in Medicare PECOS, is affiliated with St Mary's Hospital, and is a graduate of Ohio State University College Of Medicine (1991).

NPPES Registry Identity

NPI1861458630
Entity TypeIndividualMale
Primary Taxonomy207R00000X
Provider Legal NameGERALD E CRITESCredential: MD
Location Address1500 OGLETHORPE AVE STE 200CAthens, GA 30606-2165
Mailing AddressPo Box 48089Athens, GA 30604-8089 · (706) 389-3740 · Fax (706) 389-3951
Phone(706) 389-3875
Fax(706) 389-3876
Sole ProprietorNo
Medical School CMSOhio State University College Of MedicineGraduated 1991
Enumeration DateApril 21, 2006
Last NPPES UpdateMarch 4, 20263 updates tracked since enumeration
NPPES CertifiedMarch 4, 2026
✔ NPI 1861458630 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 · 63311
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.
1500 OGLETHORPE AVE STE 200C, Athens, GA 30606
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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

Gerald E Crites 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 ID6507886546
PECOS Enrollment IDI20160202001265
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.

Hospital Affiliations CMS Care Compare

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

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.

72.81/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality65.2
Promoting Interoperability78
Improvement Activities40
Cost62.51

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.

ERIC JULIAN FLORESTAN MD, MT
Internal Medicine
1500 OGLETHORPE AVE STE 200C
ATHENS, GA 30606
Clarke County (706) 389-3875
MICHELLE A NUSS MD
Internal Medicine
1500 OGLETHORPE AVE STE 200C
ATHENS, GA 30606
Clarke County (706) 389-3875
SANDRA WALL HAYES WHNP
Nurse Practitioner (Obstetrics & Gynecology)
1500 OGLETHORPE AVE STE 200C
ATHENS, GA 30606
Clarke County (706) 549-1111
DR. NAGA PRIYATHAM REDDY-MALLU MD
Student in an Organized Health Care Education/Training Program
1500 OGLETHORPE AVE STE 200C
ATHENS, GA 30606
Clarke County (706) 389-3875
SCARLETT E SCHNEIDER MD
Internal Medicine
1500 OGLETHORPE AVE STE 200C
ATHENS, GA 30606
Clarke County (706) 389-3875
BRUCE F MIDDENDORF MD
Internal Medicine
1500 OGLETHORPE AVE STE 200C
ATHENS, GA 30606
Clarke County (706) 389-3875
CYRIL MINA
Student in an Organized Health Care Education/Training Program
1500 OGLETHORPE AVE STE 200C
ATHENS, GA 30606
Clarke County (706) 389-3875
HANNAH ELIZABETH LUFT DO
Student in an Organized Health Care Education/Training Program
1500 OGLETHORPE AVE STE 200C
ATHENS, GA 30606
Clarke County (706) 389-3875

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 Gerald Crites's NPI number?

The NPI number for Gerald Crites is 1861458630. It was assigned to this individual provider in the NPPES registry on April 21, 2006.

Where is Gerald Crites located?

Gerald Crites practices at 1500 Oglethorpe Ave Ste 200C, Athens, GA 30606. The listed phone number is (706) 389-3875.

What is Gerald Crites's specialty?

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

Is Gerald Crites enrolled in Medicare?

Yes. Gerald Crites 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 Gerald Crites accept?

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

According to CMS data, Gerald Crites is affiliated with St Mary's Hospital.

When was this NPI record last updated?

The NPPES record for Gerald Crites was last updated on March 4, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.