Individual provider Active NPI

Roselyn Burton Brown, PA-C

  • Medical Physician Assistant
  • Lilburn, GA
National Provider Identifier
1013098441
Registry record updated May 10, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
005245 Issued in GA
Practice address
4153 Lawrenceville Hwy NW
Suite 5
Lilburn, GA 30047-2854
Phone
(470) 514-4301
Fax
(470) 514-4306
NPI assigned
Oct 19, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 10, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 005961 NY
Medical Physician Assistant 363AM0700X 005245 GA Primary

Addresses

Primary practice location

4153 Lawrenceville Hwy NW
Suite 5
Lilburn, GA 30047-2854

Mailing address

7901 Broadway
Managed Care, D1-01
Elmhurst, NY 11373-1329
Phone (718) 334-1921

Other identifiers 1

IdentifierTypeStateIssuer
00246075MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160229002608 GA Practitioner - Physician Assistant 8426353483 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Emory Specialty Associates, LLCGroup PAC ID 3476559782, 706 clinicians

Practice addresses (Care Compare)

1821 Clifton Rd NE
Atlanta, GA 30329-4021
Phone (404) 728-6812

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94.51 of 100Reported as apm
Quality
80.61
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
005961NYMDChiropractor
005245GAMDMedical Physician Assistant

Interoperability endpoints

  • Direct secure messaging: rbrown34910@direct.emory.org

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1161216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1368144000000",
    "number": "1013098441",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7901 BROADWAY",
            "address_2": "MANAGED CARE, D1-01",
            "city": "ELMHURST",
            "state": "NY",
            "postal_code": "113731329",
            "telephone_number": "718-334-1921",
            "fax_number": "718-334-3432"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4153 LAWRENCEVILLE HWY NW",
            "address_2": "SUITE 5",
            "city": "LILBURN",
            "state": "GA",
            "postal_code": "300472854",
            "telephone_number": "470-514-4301",
            "fax_number": "470-514-4306"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "ROSELYN",
        "middle_name": "BURTON",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-19",
        "last_updated": "2013-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "005961",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "GA",
            "license": "005245",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00246075",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lilburn, GA

Sources for this page

Verify at the official NPI Registry.