PATRICK BRYAN RAILEY M.D.
NPI 1871529032
Family Medicine in Sharpsburg, GA

Q: What is Patrick Railey's NPI number?

The NPI number for Patrick Railey is 1871529032. It was assigned to this individual provider in the NPPES registry on June 22, 2006.

Q: What is Patrick Railey's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Q: When was this NPI record last updated?

The NPPES record for Patrick Railey was last updated on January 7, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 21 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.

Active since June 22, 2006PECOS EnrolledAccepts Medicare Assignment

90.8/100

CMS Quality Rating

105 FISCHER MARKETPLACE LN STE 100, SHARPSBURG, GA 30277(678) 633-3260 Get Directions Write a Review

NPPES record last updated: January 7, 2025. Verified against the NPPES registry weekly; last sync: October 18, 2026.

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About Patrick Bryan Railey M.d. NPPES

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

PATRICK BRYAN RAILEY M.D. (NPI 1871529032) is an individual family medicine provider in Sharpsburg, Georgia, licensed in Georgia (043114) and active in the NPI registry since June 2006. He is enrolled in Medicare PECOS, is affiliated with Piedmont Hospital, and maintains a secondary practice location in Newnan.

NPPES Registry Identity

NPI1871529032

Entity TypeIndividualMale

Primary Taxonomy207Q00000X

Provider Legal NamePATRICK BRYAN RAILEYCredential: M.D.

Location Address105 FISCHER MARKETPLACE LN STE 100Sharpsburg, GA 30277-3680

Mailing AddressPo Box 102321Atlanta, GA 30368-2321 · (770) 801-2500 · Fax (770) 803-2121

Phone(678) 633-3260

Sole ProprietorNo

Medical School CMSEmory University School Of MedicineGraduated 1995

Enumeration DateJune 22, 2006

Last NPPES UpdateJanuary 7, 2025

NPPES CertifiedJanuary 7, 2025

✔ NPI 1871529032 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

License✔ Licensed in GA · 043114

Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

105 FISCHER MARKETPLACE LN STE 100, Sharpsburg, GA 30277

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Secondary Practice Location 1

Location 161 Robinson Lake RdNewnan, GA 30265-6275 · Phone (678) 633-3260 · Fax (678) 633-3278

Other Identifiers 1

Other202I085147GA · Medicare Ptan

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

Patrick Bryan Railey 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 ID6507815982

PECOS Enrollment IDI20050113000184

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 Patrick Railey reassigns Medicare billing to 5 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Piedmont Professional Services, LLC

23 mi

Nephrology

1855 HUDSON BRIDGE RD
Stockbridge, GA 30281

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

NPI 1104088905 (770) 801-2500

Piedmont Medical Care Corporation

29 mi

Internal Medicine

240 N HIGHLAND AVE NE STE F
Atlanta, GA 30307

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

NPI 1912956046 (404) 658-9840

Emory Specialty Associates, LLC

34 mi

Anesthesiology

303 SMITH ST
Lagrange, GA 30240

Reassigned Medicare billing, Georgia enrollment
1,506 clinicians in this Medicare group

NPI 1407864168 (404) 778-4888

Columbus Ambulatory Healthcare Services, Inc.

66 mi

Family Medicine

1800 10TH AVE
Columbus, GA 31901

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

NPI 1790733244 (706) 571-1120

Piedmont Athens Primary Care LLC

81 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

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 11

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.

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.

278 services209 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.

195 services195 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.

80 services66 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.

38 services27 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

Chronic care management services, first 20 minutes of clinical staff time directed by health care professional, per calendar month 99490

Chronic care management services involve a healthcare professional directing clinical staff in managing your chronic conditions. This includes the first 20 minutes per month of services like medication management, care coordination, and health monitoring to help improve your health and quality of life.

16 services16 patients

Pneumococcal conjugate vaccine, 20 valent (pcv20), for intramuscular use 90677

The Pneumococcal Conjugate Vaccine (PCV20) is a shot given to protect against 20 types of bacteria that can cause serious infections like pneumonia and meningitis. It's administered through a muscle, usually in the arm. It's important for overall health.

14 services14 patients

Administration of influenza virus vaccine G0008

The administration of the influenza virus vaccine, also known as the flu shot, is a simple procedure to protect against the flu. A healthcare provider injects a small dose of the vaccine into your arm. This stimulates your immune system to produce antibodies, which will help your body fight off the flu if exposed.

14 services14 patients

Administration of pneumococcal vaccine G0009

The pneumococcal vaccine helps protect against pneumococcal bacteria, which can cause severe infections like pneumonia and meningitis. The vaccine is given as an injection, typically in the arm. It's recommended for infants, older adults, and those with certain health conditions.

14 services14 patients

Influenza vaccine split virus, preservative free 90662

The Influenza Vaccine Split Virus, preservative-free, is a flu shot to protect against the influenza virus. It is made from parts of inactivated flu viruses and doesn't contain preservatives, reducing potential side effects. It helps your body develop immunity to the flu.

13 services13 patients

Physician or allowed practitioner certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and G0180

This is a service where a doctor or authorized practitioner certifies that you require Medicare-covered home health services. They will communicate with the home health agency and review reports on your health status to ensure you receive appropriate care. This does not involve an in-person visit.

11 services11 patients

Hospital Affiliations CMS Care Compare 3

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

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

Piedmont Fayette Hospital

Acute Care Hospitals · Fayetteville, GA

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number110215

Location1255 Highway 54 WestFayetteville, GA 30214 · Fayette County

Emergency services Birthing friendly

Piedmont Newnan Hospital, Inc

Acute Care Hospitals · Newnan, GA

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number110229

Location745 Poplar RoadNewnan, GA 30265 · Coweta County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 30277 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

$83.23 typical visit price

range $53.31 – $164.04

Typical copayment $20.80 (range $13.32 – $41.01)

Most-billed visit code 99203

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.

90.8/100

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

Scored as part of a group practice

Promoting Interoperability

Improvement Activities

Reported Quality Measures

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…

17%499 patients1/55-star benchmark: 100%

Colorectal Cancer Screening

Percentage of adults 50-75 years of age who had appropriate screening for colorectal cancer

81%358 patients4/55-star benchmark: 100%

Diabetes: Eye Exam

Percentage of patients 18-75 years of age with diabetes who had a retinal or dilated eye exam by an eye care professional during the measurement period or a negative retinal exam (no evidence of retinopathy) in the 12 months prior to the measurement period

2%98 patients1/55-star benchmark: 100%

Medication Reconciliation Post-Discharge

The percentage of discharges from any inpatient facility (e.g. hospital, skilled nursing facility, or rehabilitation facility) for patients 18 years and older of age seen within 30 days following discharge in the office by the physician, prescribing…

Patients 65+: 100% · 33 patients

100%38 patients

Pneumococcal Vaccination Status for Older Adults

Percentage of patients 65 years of age and older who have ever received a pneumococcal vaccine

92%555 patients4/55-star benchmark: 100%

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…

97%595 patients4/55-star benchmark: 100%

Preventive Care and Screening: Screening for Depression and Follow-Up Plan

Percentage of patients aged 12 years and older screened for depression on the date of the encounter using an age appropriate standardized depression screening tool AND if positive, a follow-up plan is documented on the date of the positive screen

80%519 patients4/55-star benchmark: 100%

Screening for Osteoporosis for Women Aged 65-85 Years of Age

Percentage of female patients aged 65-85 years of age who ever had a central dual-energy X-ray absorptiometry (DXA) to check for osteoporosis

74%178 patients4/55-star benchmark: 98%

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 7

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

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

DME-Other DME · category DE017N

19 suppliers72 claims150 services$5.82 avg. paid by Medicare

Normal, low and high calibrator solution / chips A4256

DME-Other DME · category DE000N

3 suppliers17 claims17 services$2.94 avg. paid by Medicare

Lancets, per box of 100 A4259

DME-Medical/Surgical Supplies · category DA000N

9 suppliers27 claims34 services$1.20 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

2 suppliers11 claims11 services$44.92 avg. paid by Medicare

Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing E0431

DME-Oxygen and Supplies · category DC000N

2 suppliers16 claims20 services$15.31 avg. paid by Medicare

Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390

DME-Oxygen and Supplies · category DC002N

2 suppliers22 claims25 services$57.93 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.

DAVID SANCHEZ NP

Nurse Practitioner (Gerontology)