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MACON MEDICAL GROUP PC
NPI 1912914847
Internal Medicine - Nephrology in Macon, GA

Active since August 02, 2006CLIA Certified · 2 labs
640 MARTIN LUTHER KING JR BLVD, SUITE 200, MACON, GA 31201(478) 745-5455(478) 745-2915 Get Directions Write a Review

NPPES record last updated: May 4, 2009. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Macon Medical Group Pc NPPES

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

MACON MEDICAL GROUP PC (NPI 1912914847) is a healthcare organization registered as a nephrology in Macon, Georgia and active in the NPI registry since August 2006. The organization holds 2 active CLIA laboratory certificates and lists Ludwig V. Cavaliere, Physician/co-owner, as its authorized official.

NPPES Registry Identity

NPI1912914847
Entity TypeOrganization
Primary Taxonomy207RN0300X
Legal Business NameMACON MEDICAL GROUP PC
Location Address640 MARTIN LUTHER KING JR BLVD, SUITE 200Macon, GA 31201-3206
Mailing Address640 Martin Luther King Jr Blvd, Suite 200Macon, GA 31201-3206 · (478) 745-5455 · Fax (478) 745-2915
Phone(478) 745-5455
Fax(478) 745-2915
Organization SubpartNo
Authorized OfficialLudwig V. CavalierePhysician/co-owner · (478) 745-5455
Enumeration DateAugust 2, 2006
Last NPPES UpdateMay 4, 2009
✔ NPI 1912914847 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · NephrologyAllopathic & Osteopathic Physicians
Taxonomy Code207RN0300X
Definition
An internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation.
640 MARTIN LUTHER KING JR BLVD, Macon, GA 31201
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Other Identifiers 4

Medicaid300025393HGA
Medicaid300025393DGA
OtherCB5310Rxr Medicare
Medicare ID-Type UnspecifiedGRP812GA

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

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 and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Macon Medical Group Pc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

10

Medicare enrollment records show 10 clinicians reassign Medicare billing to Macon Medical Group PC, which bills Medicare for the services they deliver. Of these, 5 practice at this address and 8 within 10 miles. They are listed nearest first.

Clinicians by Medicare Specialty 3

Nurse Practitioner5
Nephrology4
Internal Medicine1

Clinicians, nearest first (10)

Azmi Kabbani, MD
Nephrology
NPI 1376541078
640 MARTIN LUTHER KING JR BLVD SUITE 200
Macon, GA 31201
(478) 745-5455
✔ PECOSSame address
Swathi Singanamala, MD
Nephrology
NPI 1023275617
640 MARTIN LUTHER KING JR BLVD SUITE 200
Macon, GA 31201
(478) 745-5455
✔ PECOS✔ Accepts MedicareSame address
Ahmad Kabbani, MD
Internal Medicine
NPI 1528328796
640 MARTIN LUTHER KING JR BLVD STE 200
Macon, GA 31201
(478) 745-5455
✔ PECOS✔ Accepts MedicareSame address
Christopher Chang, NP
Nurse Practitioner
NPI 1457090110
640 MARTIN LUTHER KING JR BLVD STE 200
Macon, GA 31201
(478) 745-5455
✔ PECOS✔ Accepts MedicareSame address
Heather Self, FNP-BC
Nurse Practitioner
NPI 1336611714
640 MARTIN LUTHER KING JR BLVD STE 200
Macon, GA 31201
(478) 745-5455
✔ PECOS✔ Accepts MedicareSame address
Nicole Bello, NP-C
Nurse Practitioner
NPI 1851769293
777 HEMLOCK ST
Macon, GA 31201
(478) 633-1721
✔ PECOS0.5 mi
Deepak Kadiyala, M.D
Nephrology
NPI 1417129610
350 HOSPITAL DR
Macon, GA 31217
(478) 765-7000
✔ PECOS✔ Accepts Medicare1.2 mi
Catherine Faircloth, NP
Nurse Practitioner
NPI 1386320349
310 HOSPITAL DR STE 330
Macon, GA 31217
(478) 200-8152
✔ PECOS✔ Accepts Medicare1.2 mi
Kamilah Griswold, FNP-C
Nurse Practitioner
NPI 1669238994
1860 WATSON BLVD
Warner Robins, GA 31093
(478) 225-9001
✔ PECOS15 mi
Ifeyinwa Anigbogu, MD
Nephrology
NPI 1720243751
8570 HOSPITAL DR
Douglasville, GA 30134
(470) 227-8130
✔ PECOS✔ Accepts Medicare90 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

CLIA Laboratory Certificates CMS CLIA 2

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Accreditation 11D0264059

Macon Medical Group PC · Macon, GA
Active · expires May 18, 2028
CLIA Number11D0264059
Laboratory TypePhysician Office
Certificate Effective DateMay 19, 2026
Certificate Expiration DateMay 18, 2028
Laboratory DirectorDr. Tulsiram Prathapam
Laboratory Phone(478) 745-5455
Laboratory LocationMacon Medical Group PC640 Martin Luther King Junior Boulevard Suite 200, Macon, GA 31201
CLIA data matches this NPI record on: Name Phone
This is a certificate that is issued to a laboratory on the basis of the laboratory's accreditation by an accreditation organization approved by CMS.

Certificate of Compliance 11D2291040

Macon Medical Group, PC · Warner Robins, GA
Active · expires Sep 25, 2027
CLIA Number11D2291040
Laboratory TypePhysician Office
Certificate Effective DateSeptember 26, 2025
Certificate Expiration DateSeptember 25, 2027
Laboratory DirectorAhmad Kabbani
Laboratory Phone(478) 745-5455
Laboratory LocationMacon Medical Group, PC309 Osigian Blvd, Warner Robins, GA 31088
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.

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 Macon Medical Group PC's NPI number?

The NPI number for Macon Medical Group PC is 1912914847. It was assigned to this organization in the NPPES registry on August 2, 2006.

Where is Macon Medical Group PC located?

Macon Medical Group PC is located at 640 Martin Luther King Jr Blvd Suite 200, Macon, GA 31201. The listed phone number is (478) 745-5455.

What is Macon Medical Group PC's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Nephrology, with taxonomy code 207RN0300X.

Is Macon Medical Group PC enrolled in Medicare?

Yes. Macon Medical Group PC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Macon Medical Group PC?

According to the CMS Revalidation Reassignment List (October 2026 release), 10 clinicians in 3 Medicare specialties reassign their Medicare billing to Macon Medical Group PC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Nurse Practitioner (5), Nephrology (4) and Internal Medicine (1). Of these, 5 practice at this address and 8 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Macon Medical Group PC hold CLIA laboratory certificates?

Yes. 2 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.

What insurance does Macon Medical Group PC 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 Macon Medical Group PC 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.

When was this NPI record last updated?

The NPPES record for Macon Medical Group PC was last updated on May 4, 2009. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 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.