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RICHARD J BRECKWOLDT M.D.
NPI 1942297106
Internal Medicine in Hiram, GA

Active since October 04, 2005PECOS EnrolledAccepts Medicare Assignment
90.8/100
CMS Quality Rating
5604 WENDY BAGWELL PKWY, SUITE 711, HIRAM, GA 30141(678) 384-0800(678) 384-0801 Get Directions Write a Review

NPPES record last updated: June 16, 2014. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Richard J Breckwoldt M.d. NPPES

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

RICHARD J BRECKWOLDT M.D. (NPI 1942297106) is an individual internal medicine provider in Hiram, Georgia, licensed in Georgia (039295) and active in the NPI registry since October 2005. He is enrolled in Medicare PECOS, is affiliated with Piedmont Cartersville Medical Center, and is a graduate of New York Medical College (1988).

NPPES Registry Identity

NPI1942297106
Entity TypeIndividualMale
Primary Taxonomy207R00000X
Provider Legal NameRICHARD J BRECKWOLDTCredential: M.D.
Location Address5604 WENDY BAGWELL PKWY, SUITE 711Hiram, GA 30141-7813
Mailing Address5604 Wendy Bagwell Pkwy, Suite 711Hiram, GA 30141-7813 · (678) 384-0800 · Fax (678) 384-0801
Phone(678) 384-0800
Fax(678) 384-0801
Sole ProprietorYes
Medical School CMSNew York Medical CollegeGraduated 1988
Enumeration DateOctober 4, 2005
Last NPPES UpdateJune 16, 2014
✔ NPI 1942297106 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
Licenses✔ Licensed in GA · 039295✔ Licensed in GA · 39295
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.
5604 WENDY BAGWELL PKWY, Hiram, GA 30141
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Other Identifiers 3

Medicare PINGRP7410GA
Medicare UPINF43359GA
Medicaid000656103BGA

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Alliant Health Plans, Inc..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

Richard J Breckwoldt 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 ID2264459908
PECOS Enrollment IDI20051101000439
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 7

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.
506 services252 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.
441 services229 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 services90 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.
77 services74 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.
75 services72 patients
Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report 93000
An electrocardiogram (ECG) is a non-invasive test that records your heart's electrical activity. Using 12 leads attached to your body, it captures data to help identify heart conditions. A doctor interprets the results and provides a report.
22 services21 patients

Hospital Affiliations CMS Care Compare 5

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

Piedmont Cartersville Medical Center

Acute Care Hospitals · Cartersville, GA
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number110030
Location960 Joe Frank Harris ParkwayCartersville, GA 30120 · Bartow County
Emergency services Birthing friendly

Wellstar Paulding Medical Center

Acute Care Hospitals · Hiram, GA
4/5 CMS rating
OwnershipVoluntary non-profit - Other
CMS Certification Number110042
Location2518 Jimmy Lee Smith ParkwayHiram, GA 30141 · Paulding County

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

Wellstar Cobb Medical Center

Acute Care Hospitals · Austell, GA
2/5 CMS rating
OwnershipVoluntary non-profit - Other
CMS Certification Number110143
Location3950 Austell RdAustell, GA 30106 · Cobb County
Birthing friendly

Wellstar Douglas Medical Center

Acute Care Hospitals · Douglasville, GA
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number110184
Location8954 Hospital DriveDouglasville, GA 30134 · Douglas County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 30141 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.

90.8/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Promoting Interoperability98
Improvement Activities20

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…
7%289 patients1/55-star benchmark: 100%
Colorectal Cancer Screening
Percentage of adults 50-75 years of age who had appropriate screening for colorectal cancer
78%216 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
1%76 patients1/55-star benchmark: 100%
Pneumococcal Vaccination Status for Older Adults
Percentage of patients 65 years of age and older who have ever received a pneumococcal vaccine
83%289 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…
87%333 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
81%258 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
52%138 patients3/55-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 2

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
6 suppliers25 claims52 services$6.69 avg. paid by Medicare
Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service K0553
DME-Other DME · category DE017N
3 suppliers20 claims20 services$202.96 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 14

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

JOHN MARLIN WARREN CNMT
Radiologic Technologist (Nuclear Medicine Technology)
5604 WENDY BAGWELL PKWY, SUITE 911
HIRAM, GA 30141
Paulding County (678) 384-1711
SYNERGY HOMECARE OF NW ATLANTA
In Home Supportive Care
5604 WENDY BAGWELL PKWY, SUITE 321
HIRAM, GA 30141
Paulding County (678) 909-3043
PEDIATRIC DENTAL SPECIALIST OF HIRAM
Dentist (Pediatric Dentistry)
5604 WENDY BAGWELL PKWY, SUITE 1100
HIRAM, GA 30141
Paulding County (770) 943-0011
BYRON T BARNES NMTCB
Radiologic Technologist (Nuclear Medicine Technology)
5604 WENDY BAGWELL PKWY
HIRAM, GA 30141
Paulding County (678) 384-1711
ANDRE T AYERS NMTCB
Radiologic Technologist (Nuclear Medicine Technology)
5604 WENDY BAGWELL PKWY
HIRAM, GA 30141
Paulding County (678) 384-1711
EMPOWERED2CHANGE LLC
Social Worker (Clinical)
5604 WENDY BAGWELL PKWY, SUITE 812
HIRAM, GA 30141
Paulding County (678) 602-9709
PINNACLE PEDIATRICS PC
Pediatrics
5604 WENDY BAGWELL PKWY, SUITE 1111
HIRAM, GA 30141
Paulding County (678) 944-0060
ANDREA BATTAGLIA LSCW
Counselor (Mental Health)
5604 WENDY BAGWELL PKWY, SUITE 411
HIRAM, GA 30141
Paulding County (404) 246-7470

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 Richard Breckwoldt's NPI number?

The NPI number for Richard Breckwoldt is 1942297106. It was assigned to this individual provider in the NPPES registry on October 4, 2005.

Where is Richard Breckwoldt located?

Richard Breckwoldt practices at 5604 Wendy Bagwell Pkwy Suite 711, Hiram, GA 30141. The listed phone number is (678) 384-0800.

What is Richard Breckwoldt's specialty?

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

Is Richard Breckwoldt enrolled in Medicare?

Yes. Richard Breckwoldt 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 Richard Breckwoldt accept?

Health plans from Alliant Health Plans, Inc. list Richard Breckwoldt 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 Richard Breckwoldt affiliated with any hospitals?

According to CMS data, Richard Breckwoldt is affiliated with Piedmont Cartersville Medical Center, Wellstar Paulding Medical Center, Piedmont Hospital, Wellstar Cobb Medical Center and Wellstar Douglas Medical Center.

When was this NPI record last updated?

The NPPES record for Richard Breckwoldt was last updated on June 16, 2014. NPI Profile syncs with the weekly NPPES data releases published by CMS.