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THOMAS A HILSMAN M.D.
NPI 1922093665
Family Medicine in Dawson, GA

Active since September 19, 2005PECOS EnrolledAccepts Medicare Assignment
771 ROUNDTREE DR SW STE A, DAWSON, GA 39842(229) 270-1905(229) 270-1915 Get Directions Write a Review

NPPES record last updated: June 9, 2023. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Thomas A Hilsman M.d. NPPES

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

THOMAS A HILSMAN M.D. (NPI 1922093665) is an individual family medicine provider in Dawson, Georgia, licensed in Georgia (015591) and active in the NPI registry since September 2005. He is enrolled in Medicare PECOS and is a graduate of Medical College Of Georgia School Of Medicine (1972).

NPPES Registry Identity

NPI1922093665
Entity TypeIndividualMale
Primary Taxonomy207Q00000X
Provider Legal NameTHOMAS A HILSMANCredential: M.D.
Location Address771 ROUNDTREE DR SW STE ADawson, GA 39842-1683
Mailing Address771 Roundtree Dr Sw Ste ADawson, GA 39842-1683 · (229) 270-1905 · Fax (229) 270-1915
Phone(229) 270-1905
Fax(229) 270-1915
Sole ProprietorNo
Medical School CMSMedical College Of Georgia School Of MedicineGraduated 1972
Enumeration DateSeptember 19, 2005
Last NPPES UpdateJune 9, 2023
NPPES CertifiedJune 9, 2023
✔ NPI 1922093665 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 · 015591
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.
771 ROUNDTREE DR SW STE A, Dawson, GA 39842
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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, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Thomas A Hilsman 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 ID6608040647
PECOS Enrollment IDI20111201000093
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.

Detection test by immunoassay with direct visual observation for influenza virus 87804
This is a test that identifies the influenza virus in your body. It works by using an immunoassay, a method that detects the presence of the virus through an immune response. The results are directly observable, making it a quick and efficient way to diagnose flu.
182 services85 patients
Detection test by immunoassay technique for severe acute respiratory syndrome coronavirus 87426
An immunoassay test for severe acute respiratory syndrome coronavirus is a diagnostic tool. It uses your body's immune response to detect the presence of the virus. It involves taking a sample, usually from your nose or throat, which is then analyzed in a lab for signs of the virus.
95 services89 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.
94 services50 patients
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.
85 services65 patients
Detection test by immunoassay with direct visual observation for streptococcus, group a (strep) 87880
A detection test by immunoassay for Group A Strep is a quick procedure to identify a bacterial infection in your throat. It involves taking a throat swab and applying it to a test strip, which changes color if Strep bacteria are present.
81 services75 patients
Urine microalbumin (protein) analysis 82044
Urine microalbumin analysis is a test that measures the amount of a protein called albumin in your urine. This protein is usually present in very small amounts, but higher levels can indicate kidney issues. The test is non-invasive and involves a simple urine sample.
33 services22 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 39842 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.

Reported Quality Measures

Breast Cancer Screening
Percentage of women 50-74 years of age who had a mammogram to screen for breast cancer
52%311 patients3/55-star benchmark: 92%
Colorectal Cancer Screening
Percentage of adults 50-75 years of age who had appropriate screening for colorectal cancer
54%782 patients3/55-star benchmark: 85%
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
20%287 patients1/55-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.
97%5,559 patients4/55-star benchmark: 99%
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…
48%147 patients3/55-star benchmark: 88%
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.
59%260 patients1/55-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.
61%1,325 patients3/55-star benchmark: 97%
Preventive Care and Screening: Influenza Immunization
Percentage of patients aged 6 months and older seen for a visit between October 1 and March 31 who received an influenza immunization OR who reported previous receipt of an influenza immunization
25%1,081 patients2/55-star benchmark: 88%
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…
100%1,325 patients5/55-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…
33%1,325 patients2/55-star benchmark: 89%
View, Download, or Transmit (VDT)
At least one patient seen by the MIPS eligible clinician during the performance period (or patient-authorized representative) views, downloads or transmits their health information to a third party during the performance period.
38%1,325 patients
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.

Other Providers at the Same Location NPPES 4

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

MEGAN ELMORE FNP
Nurse Practitioner (Family)
771 ROUNDTREE DR SW STE A
DAWSON, GA 39842
Terrell County (229) 270-1905
WHITTNYE BARKSDALE NP-C
Nurse Practitioner (Family)
771 ROUNDTREE DR SW STE A
DAWSON, GA 39842
Terrell County (229) 270-1905
ANTHONY LANCE GREGORY NP
Nurse Practitioner (Family)
771 ROUNDTREE DR SW STE A
DAWSON, GA 39842
Terrell County (229) 270-1905
CARECONNECT HEALTH, INC.
Clinic/Center (Federally Qualified Health Center (FQHC))
771 ROUNDTREE DR SW STE A
DAWSON, GA 39842
Terrell County (229) 270-1905

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 Thomas Hilsman's NPI number?

The NPI number for Thomas Hilsman is 1922093665. It was assigned to this individual provider in the NPPES registry on September 19, 2005.

Where is Thomas Hilsman located?

Thomas Hilsman practices at 771 Roundtree Dr SW Ste A, Dawson, GA 39842. The listed phone number is (229) 270-1905.

What is Thomas Hilsman's specialty?

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

Is Thomas Hilsman enrolled in Medicare?

Yes. Thomas Hilsman 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 Thomas Hilsman 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 Thomas Hilsman 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 Thomas Hilsman was last updated on June 9, 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.