Active NPI 1750566493 Individual Practitioner Female Practitioner

Sumona Smith

Surgery - Vascular Surgery • Braselton, GA

✓ Accepts Medicare Assignment

Professional Overview & Biography Verified Profile Summary

Sumona Smith is a certified Surgery - Vascular Surgery practicing in Braselton, GA. With approximately 24 years of clinical experience since completing medical education in 2002, Sumona Smith delivers high-quality medical care to the local community at 1404 RIVER PL.

Sumona Smith is affiliated with Atlanta Heart Associates Pc and accepts Medicare assignment.

Frequently performed procedures and clinical services include established patient outpatient office visit, ultrasound of both sides of head and neck blood flow, ultrasound study of arm or leg veins with compression and maneuvers. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

1404 River Pl
Suite 201

Braselton, GA 305175600

Telephone 7702194000

Fax 7702194001

Associated Practice Facility / Clinic

🏢 Cornerstone Surgery Of Braselton, Pc Facility NPI 1962809285

Medicare Profile & Education

Medical School

Other

Graduation Year

2002

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

In-Person Only

Specialty Benchmarks & Practice Insights

Comparative analytics for Surgery - Vascular Surgery in Braselton, GA

Senior Veteran Specialist (>20 Yrs)

Practitioner Clinical Experience

24 Yrs +3.7 yrs vs City Avg

City Avg: 20.3 Yrs

State Avg: 23.4 Yrs

Regional Practice Density

3 Specialists

Practicing in Braselton, GA (194 Statewide)

Telehealth Adoption Rate

66.7% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount

70.3% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Smith (24 Years) 24 Yrs

Braselton Specialty Average (20.3 Years) 20.3 Yrs

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2024)

Reporting Year:

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	117	84	$200.00	$88.31
93880 Ultrasound of both sides of head and neck blood flow	116	116	$840.00	$176.33
93970 Ultrasound study of arm or leg veins with compression and maneuvers	69	66	$700.00	$176.92
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	60	60	$250.00	$109.17
93970 Ultrasound study of arm or leg veins with compression and maneuvers	42	41	$100.00	$32.01
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	36	34	$250.00	$125.77
93971 Ultrasound scan of veins of one arm or leg or limited including assessment of compression and functional maneuvers	35	35	$100.00	$20.42
93925 Ultrasound of leg arteries or artery grafts	31	31	$850.00	$232.20
93880 Ultrasound of both sides of head and neck blood flow	21	21	$150.00	$36.96
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	13	13	$350.00	$127.95

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
93970 Ultrasound study of arm or leg veins with compression and maneuvers	169	162	$89.00	$32.42
93880 Ultrasound of both sides of head and neck blood flow	116	115	$92.19	$37.35
93971 Ultrasound scan of veins of one arm or leg or limited including assessment of compression and functional maneuvers	114	110	$227.00	$20.84
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	88	81	$88.59	$53.22
93922 Ultrasound study of arm and leg arteries	81	75	$34.00	$11.96
99213 Established patient office or other outpatient visit, typically 15 minutes	59	52	$145.49	$85.90
76937 Ultrasonic guidance for blood vessel access	54	43	$50.00	$13.69
93925 Ultrasound of leg arteries or artery grafts	50	50	$79.00	$36.41
99152 Moderate sedation services by physician also performing a procedure, patient 5 years of age or older, first 15 minutes	48	42	$156.00	$12.27
93926 Ultrasound of one leg arteries or artery grafts	43	39	$247.00	$22.26
93978 Complete ultrasound of aorta, vena cava, groin vessels or bypass grafts	42	41	$85.00	$37.18
93990 Ultrasound of dialysis access	32	23	$245.00	$22.33
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	20	20	$221.20	$106.82
75625 Radiological supervision and interpretation X-ray of abdominal aorta	15	14	$180.00	$65.93
36902 Insertion of needle and/or tube into hemodialysis circuit and balloon dilation of dialysis segment with review by radiologist	13	12	$3720.85	$213.68
99221 Initial hospital inpatient care per day, typically 30 minutes	12	12	$209.67	$81.00
36558 Insertion of tunneled central venous tube for infusion (5 years or older)	12	12	$3449.33	$250.44

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
93970 Ultrasound study of arm or leg veins with compression and maneuvers	390	366	$89.00	$32.95
93880 Ultrasound of both sides of head and neck blood flow	244	217	$74.00	$38.11
93971 Ultrasound scan of veins of one arm or leg or limited including assessment of compression and functional maneuvers	214	207	$227.00	$21.15
93922 Ultrasound study of arm and leg arteries	155	132	$34.00	$12.06
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	149	125	$88.00	$53.69
76937 Ultrasonic guidance for blood vessel access	147	101	$50.00	$13.51
99152 Moderate sedation services by physician also performing a procedure, patient 5 years of age or older, first 15 minutes	123	87	$156.00	$12.38
99213 Established patient office or other outpatient visit, typically 15 minutes	98	87	$130.00	$86.68
93925 Ultrasound of leg arteries or artery grafts	90	85	$79.00	$37.62
93926 Ultrasound of one leg arteries or artery grafts	82	65	$247.00	$22.89
93990 Ultrasound of dialysis access	72	45	$245.00	$23.58
93978 Complete ultrasound of aorta, vena cava, groin vessels or bypass grafts	58	54	$85.00	$37.53
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	57	57	$217.00	$107.26
36558 Insertion of tunneled central venous tube for infusion (5 years or older)	42	33	$2850.00	$244.66
36902 Insertion of needle and/or tube into hemodialysis circuit and balloon dilation of dialysis segment with review by radiologist	41	33	$2931.00	$219.97
75625 Radiological supervision and interpretation X-ray of abdominal aorta	30	26	$180.00	$67.28
93975 Complete ultrasound of abdomen and pelvis artery and vein blood flow	25	24	$521.00	$54.56
99442 Telephone medical discussion with physician, 11-20 minutes	18	18	$93.00	$86.33
37228 Balloon dilation of artery of leg, initial vessel	17	15	$19027.00	$514.16
75630 Review by radiologist of abdominal aorta and both leg arteries image	17	16	$250.00	$93.42
35301 Removal of blood clot and portion of artery of neck	16	15	$3904.00	$1108.27
36821 Relocation of arm vein with connection to arm artery, open procedure	14	14	$2500.00	$644.36
99221 Initial hospital inpatient care per day, typically 30 minutes	14	14	$210.00	$96.97
93930 Ultrasound study of arteries and arterial grafts of both arms	14	14	$326.00	$38.09
93985 Complete ultrasound of artery and vein blood flow pre-op assessment on both sides of body for hemodialysis access	13	13	$184.00	$37.48
93931 Ultrasound of one arm arteries or artery grafts	13	12	$43.00	$23.57

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
93970 Ultrasound study of arm or leg veins with compression and maneuvers	392	377	$89.00	$33.01
93880 Ultrasound of both sides of head and neck blood flow	293	272	$71.00	$38.24
93971 Ultrasound scan of veins of one arm or leg or limited including assessment of compression and functional maneuvers	209	194	$227.00	$21.48
93922 Ultrasound study of arm and leg arteries	183	141	$34.00	$12.59
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	166	139	$88.00	$53.53
76937 Ultrasonic guidance for blood vessel access	153	108	$50.00	$13.68
99152 Moderate sedation services by physician also performing a procedure, patient 5 years of age or older, first 15 minutes	91	69	$156.00	$12.27
99213 Established patient office or other outpatient visit, typically 15 minutes	83	68	$128.00	$87.91
93925 Ultrasound of leg arteries or artery grafts	81	78	$79.00	$37.62
93978 Complete ultrasound of aorta, vena cava, groin vessels or bypass grafts	78	68	$85.00	$38.56
93926 Ultrasound of one leg arteries or artery grafts	77	56	$247.00	$23.29
93990 Ultrasound of dialysis access	70	48	$245.00	$23.96
36558 Insertion of tunneled central venous tube for infusion (5 years or older)	45	37	$2794.00	$255.31
36902 Insertion of needle and/or tube into hemodialysis circuit and balloon dilation of dialysis segment with review by radiologist	39	27	$2846.00	$225.29
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	28	28	$217.00	$106.07
75625 Radiological supervision and interpretation X-ray of abdominal aorta	26	24	$180.00	$68.15
93975 Complete ultrasound of abdomen and pelvis artery and vein blood flow	21	19	$521.00	$55.65
99441 Telephone medical discussion with physician, 5-10 minutes	20	19	$47.00	$46.92
93930 Ultrasound study of arteries and arterial grafts of both arms	19	19	$326.00	$38.88
99442 Telephone medical discussion with physician, 11-20 minutes	18	18	$77.00	$77.90
75630 Review by radiologist of abdominal aorta and both leg arteries image	16	15	$250.00	$95.10
37226 Insertion of stent in arteries of leg	14	13	$31001.00	$441.97
36246 Insertion of tube into abdominal, pelvic, or leg artery, initial second order branch	12	12	$4996.00	$245.16
35301 Removal of blood clot and portion of artery of neck	12	12	$3828.00	$1049.04
76706 Ultrasound scan of abdominal aorta	12	12	$209.00	$27.02

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
93970 Ultrasound study of arm or leg veins with compression and maneuvers	346	336	$89.00	$34.44
93880 Ultrasound of both sides of head and neck blood flow	259	234	$70.26	$39.93
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	226	182	$88.00	$43.51
93971 Ultrasound scan of veins of one arm or leg or limited including assessment of compression and functional maneuvers	191	181	$227.00	$22.27
93922 Ultrasound study of arm and leg arteries	172	137	$34.00	$12.72
76937 Ultrasonic guidance for blood vessel access	146	114	$50.00	$14.49
99152 Moderate sedation services by physician also performing a procedure, patient 5 years of age or older, first 15 minutes	93	78	$156.00	$12.43
99213 Established patient office or other outpatient visit, typically 15 minutes	82	74	$128.00	$72.57
93990 Ultrasound of dialysis access	78	58	$245.00	$25.27
93978 Complete ultrasound of aorta, vena cava, groin vessels or bypass grafts	71	63	$85.00	$39.34
93925 Ultrasound of leg arteries or artery grafts	69	66	$79.00	$38.88
93926 Ultrasound of one leg arteries or artery grafts	68	53	$247.00	$24.56
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	60	60	$217.00	$100.76
75625 Radiological supervision and interpretation X-ray of abdominal aorta	46	40	$152.65	$71.03
36902 Insertion of needle and/or tube into hemodialysis circuit and balloon dilation of dialysis segment with review by radiologist	38	30	$2779.55	$243.25
99221 Initial hospital inpatient care per day, typically 30 minutes	31	30	$210.00	$101.45
36558 Insertion of tunneled central venous tube for infusion (5 years or older)	25	18	$2743.40	$259.27
93975 Complete ultrasound of abdomen and pelvis artery and vein blood flow	21	21	$521.00	$56.56
37228 Balloon dilation of artery of leg, initial vessel	15	13	$18362.20	$545.30
99441 Telephone medical discussion with physician, 5-10 minutes	15	15	$45.60	$43.11
99442 Telephone medical discussion with physician, 11-20 minutes	15	15	$76.00	$72.76
93930 Ultrasound study of arteries and arterial grafts of both arms	13	12	$326.00	$40.30
35301 Removal of blood clot and portion of artery of neck	13	12	$3720.77	$1166.98
36907 Balloon dilation of dialysis segment with review by radiologist	11	11	$2024.00	$151.19

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
93970 Ultrasound study of arm or leg veins with compression and maneuvers	461	444	$89.00	$34.48
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	453	358	$88.00	$43.00
93880 Ultrasound of both sides of head and neck blood flow	312	262	$70.00	$40.24
93971 Ultrasound scan of veins of one arm or leg or limited including assessment of compression and functional maneuvers	265	250	$97.54	$22.47
93922 Ultrasound study of arm and leg arteries	228	180	$34.00	$12.74
76937 Ultrasonic guidance for blood vessel access	169	119	$50.00	$14.47
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	145	145	$217.00	$104.71
93990 Ultrasound of dialysis access	139	91	$245.00	$24.80
99152 Moderate sedation services by physician also performing a procedure, patient 5 years of age or older, first 15 minutes	119	93	$156.00	$12.36
93925 Ultrasound of leg arteries or artery grafts	106	96	$79.00	$39.59
93926 Ultrasound of one leg arteries or artery grafts	77	66	$80.70	$24.45
93978 Complete ultrasound of aorta, vena cava, groin vessels or bypass grafts	68	61	$85.00	$39.71
36902 Insertion of needle and/or tube into hemodialysis circuit and balloon dilation of dialysis segment with review by radiologist	55	44	$792.09	$236.31
75625 Radiological supervision and interpretation X-ray of abdominal aorta	44	39	$146.00	$56.13
36558 Insertion of tunneled central venous tube for infusion (5 years or older)	40	30	$2472.50	$259.93
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	29	29	$255.00	$135.69
93975 Complete ultrasound of abdomen and pelvis artery and vein blood flow	27	21	$257.89	$57.90
93930 Ultrasound study of arteries and arterial grafts of both arms	26	25	$143.77	$38.53
36821 Relocation of arm vein with connection to arm artery, open procedure	25	22	$1978.00	$659.56
93924 Ultrasound study of arteries of both legs at rest and exercise	22	22	$65.00	$24.78
35301 Removal of blood clot and portion of artery of neck	20	20	$3566.00	$1124.50
76998 Ultrasonic guidance during surgery	17	17	$208.00	$61.09
37221 Insertion of stents in artery in one side of groin, endovascular, accessed through the skin or open procedure	14	14	$17506.36	$607.37
36907 Balloon dilation of dialysis segment with review by radiologist	14	14	$2024.00	$151.34
75710 Radiological supervision and interpretation of imaging of artery of one arm or leg	14	14	$165.00	$87.00
36832 Revision of dialysis graft, open procedure	14	13	$1743.00	$776.96
37228 Balloon dilation of artery of leg, initial vessel	14	14	$13635.43	$524.36
93931 Ultrasound of one arm arteries or artery grafts	13	12	$40.46	$24.78

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
93970 Ultrasound study of arm or leg veins with compression and maneuvers	563	543	$89.00	$33.58
93971 Ultrasound scan of veins of one arm or leg or limited including assessment of compression and functional maneuvers	393	367	$58.00	$21.75
93880 Ultrasound of both sides of head and neck blood flow	355	319	$70.00	$39.12
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	296	225	$88.00	$41.22
93922 Ultrasound study of arm and leg arteries	233	181	$34.00	$12.29
76937 Ultrasonic guidance for blood vessel access	157	108	$50.00	$13.72
99152 Moderate sedation services by physician also performing a procedure, patient 5 years of age or older, first 15 minutes	136	93	$72.56	$12.28
93925 Ultrasound of leg arteries or artery grafts	127	113	$79.00	$38.49
93990 Ultrasound of dialysis access	119	70	$474.46	$23.37
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	104	104	$217.00	$100.11
93926 Ultrasound of one leg arteries or artery grafts	79	59	$50.00	$23.48
93978 Complete ultrasound of aorta, vena cava, groin vessels or bypass grafts	64	58	$85.00	$39.45
36471 Injection of chemical agent into multiple incompetent veins of leg	54	22	$654.00	$178.62
75625 Radiological supervision and interpretation X-ray of abdominal aorta	45	37	$146.00	$54.37
93975 Complete ultrasound of abdomen and pelvis artery and vein blood flow	41	37	$225.00	$56.64
36902 Insertion of needle and/or tube into hemodialysis circuit and balloon dilation of dialysis segment with review by radiologist	39	34	$660.00	$225.04
93930 Ultrasound study of arteries and arterial grafts of both arms	36	36	$120.00	$38.30
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	31	30	$255.00	$128.30
93924 Ultrasound study of arteries of both legs at rest and exercise	30	30	$65.00	$24.42
35301 Removal of blood clot and portion of artery of neck	25	23	$3494.68	$1116.97
36558 Insertion of tunneled central venous tube for infusion (5 years or older)	24	21	$2467.00	$248.43
36475 Destruction of insufficient vein of arm or leg, accessed through the skin	22	13	$7882.00	$1304.08
36247 Insertion of tube into abdominal, pelvic, or leg artery, initial third order branch	20	18	$7939.00	$208.58
75710 Radiological supervision and interpretation of imaging of artery of one arm or leg	20	17	$165.00	$85.67
36821 Relocation of arm vein with connection to arm artery, open procedure	19	19	$1978.00	$674.93
99213 Established patient office or other outpatient visit, typically 15 minutes	18	18	$128.00	$69.69
36905 Excision of blood clot and/or infusion to dissolve blood clot in dialysis circuit and balloon dilation of dialysis segment, , accessed through the skin, with imaging including radiological supervision and interpretation, with balloon catheter	18	15	$1306.00	$424.80
93923 Complete ultrasound study of arm and leg arteries	18	18	$45.00	$22.00
93931 Ultrasound of one arm arteries or artery grafts	15	14	$40.00	$24.39
G0365 Vessel mapping of vessels for hemodialysis access (services for preoperative vessel mapping prior to creation of hemodialysis access using an autogenous hemodialysis conduit, including arterial inflow and venous outflow)	11	11	$565.00	$12.25
37226 Insertion of stent in arteries of leg	11	11	$27798.00	$462.85

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
93970 Ultrasound study of arm or leg veins with compression and maneuvers	324	313	$242.64	$33.81
93971 Ultrasound scan of veins of one arm or leg or limited including assessment of compression and functional maneuvers	247	234	$157.75	$21.70
93880 Ultrasound of both sides of head and neck blood flow	211	192	$203.25	$39.13
93923 Complete ultrasound study of arm and leg arteries	123	110	$217.36	$21.97
99213 Established patient office or other outpatient visit, typically 15 minutes	112	96	$128.00	$68.47
76937 Ultrasonic guidance for blood vessel access	86	69	$49.37	$14.15
93925 Ultrasound of leg arteries or artery grafts	83	80	$230.28	$38.27
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	76	70	$88.00	$40.89
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	62	62	$217.00	$101.35
93922 Ultrasound study of arm and leg arteries	60	56	$43.92	$12.42
99152 Moderate sedation services by physician also performing a procedure, patient 5 years of age or older, first 15 minutes	56	47	$44.32	$12.06
93926 Ultrasound of one leg arteries or artery grafts	52	41	$183.06	$23.86
G0365 Vessel mapping of vessels for hemodialysis access (services for preoperative vessel mapping prior to creation of hemodialysis access using an autogenous hemodialysis conduit, including arterial inflow and venous outflow)	48	32	$198.56	$12.10
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	36	34	$184.00	$101.86
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	32	32	$306.00	$156.40
93930 Ultrasound study of arteries and arterial grafts of both arms	24	24	$235.33	$39.30
75710 Radiological supervision and interpretation of imaging of artery of one arm or leg	21	18	$525.36	$55.27
93978 Complete ultrasound of aorta, vena cava, groin vessels or bypass grafts	21	21	$114.43	$39.05
75625 Radiological supervision and interpretation X-ray of abdominal aorta	21	20	$411.86	$54.96
36247 Insertion of tube into abdominal, pelvic, or leg artery, initial third order branch	17	14	$7939.00	$198.32
36558 Insertion of tunneled central venous tube for infusion (5 years or older)	16	15	$2467.00	$232.89
76705 Limited ultrasound scan of abdomen	16	14	$133.50	$28.90
36902 Insertion of needle and/or tube into hemodialysis circuit and balloon dilation of dialysis segment with review by radiologist	16	15	$660.00	$209.64
93990 Ultrasound of dialysis access	15	14	$387.40	$24.30
93924 Ultrasound study of arteries of both legs at rest and exercise	15	14	$210.20	$24.48
93979 Ultrasound scan of blood flow of aorta, vena cava, bypass graphs, or one side of the groin or limited scan	13	13	$134.08	$24.51
36821 Relocation of arm vein with connection to arm artery, open procedure	11	11	$1969.27	$668.65
93975 Complete ultrasound of abdomen and pelvis artery and vein blood flow	11	11	$225.00	$56.84
76770 Complete ultrasound scan behind abdominal cavity	11	11	$171.50	$36.10

Medical Specialties & State Licenses

CMS Verified: 2020-10-15

Surgery - Vascular Surgery Primary Specialty

NUCC Taxonomy Code: 2086S0129X

State License GA 054343

A surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart.

Surgery

NUCC Taxonomy Code: 208600000X

State License GA 054343

A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery.

Surgery

NUCC Taxonomy Code: 208600000X

State License MS 21693

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID

174387 (AL)

Medicaid State Provider ID

2359673 (LA)

Commercial Insurance / Payer ID Railroad Medicare Ptan

P01006900 (MS)

Commercial Insurance / Payer ID Railroad Medicare

P01251951 (MS)

Hospital & Practice Group Affiliations

Atlanta Heart Associates Pc

3333 Jodeco Rd, Mcdonough, GA 302535319

Phone: 7706924000

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

17 Associated Practitioners

Kierney Jackson , PA

Physician Assistant

NPI 1003057621

Physician Assistant

Angie Rodriguez , PA-C

Physician Assistant

NPI 1043722630

Physician Assistant (Certified)

Dr. Phillip Rideout , MD

Surgery - Vascular Surgery

NPI 1093153116

Doctor of Medicine (M.D.)

Kendyl Burke , PA

Physician Assistant

NPI 1164962718

Physician Assistant

Dr. William Zickler , MD

Surgery - Vascular Surgery

NPI 1245764042

Doctor of Medicine (M.D.)

Omar Abu-Alrub , AGACNP

Nurse Practitioner - Acute Care

NPI 1265162622

Adult-Gerontology Acute Care Nurse Practitioner

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) October 15, 2020

Surgery (License #21693 in MS)

✅

NPI Profile Active October 26, 2016

NPI status registered as active in NPPES database

📍

Updated Practice Location October 26, 2016

Registered at 1404 RIVER PL, SUITE 201, BRASELTON, GA 305175600 (Tel: 7702194000)

📍

Updated Business Mailing Address October 26, 2016

Registered at PO BOX 742616, ATLANTA, GA 303742616 (Tel: 7702194000)

👤

Provider Name / Credentials Updated October 26, 2016

Recorded as SUMONA SMITH

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) October 26, 2016

Surgery (License #054343 in GA)

🟢

Initial NPI Registration & Enumeration December 31, 2007

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

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NPI Administrative Meta

NPI Number: 1750566493

Entity Type:

Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)

Enumeration Date: December 31, 2007

Last Update: October 15, 2020

Sole Proprietor: No

Update or Correct Profile

Mailing Address

Po Box 742616

Atlanta, GA 303742616

Phone: 7702198420

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).

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