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Organization Active NPI

Orthoatlanta, LLC

  • Orthopaedic Surgery Physician
  • Lawrenceville, GA
National Provider Identifier
1043331978
Registry record updated Mar 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
Legal business name
ORTHOATLANTA, LLC
Practice address
771 Old Norcross Rd
Suites 155 / 390
Lawrenceville, GA 30046-4386
Phone
(678) 205-4261
Fax
(947) 417-7187
NPI assigned
Apr 2, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2025

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

Authorized official

Name
Michael Ochal
Title
Ceo
Phone
(770) 953-6929

Specialties & licenses 8

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207X00000X GA Primary
Orthopaedic Hand Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207XS0106X
Adult Reconstructive Orthopaedic Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207XS0114X
Orthopaedic Foot and Ankle Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207XX0004X
Sports Medicine (Orthopaedic Surgery) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207XX0005X GA
Pain Medicine (Physical Medicine & Rehabilitation) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2081P2900X GA
Orthopedic Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 2251X0800X GA
Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363A00000X GA

Addresses

Primary practice location

771 Old Norcross Rd
Suites 155 / 390
Lawrenceville, GA 30046-4386

Mailing address

3100 Interstate North Cir SE Ste 500
Atlanta, GA 30339-2296
Phone (770) 953-6929

Other identifiers 3

IdentifierTypeStateIssuer
6285940003OtherGADME (ALSO MEDICARE NSC)
6285940012OtherGANSC - DME (#155)
346603704OtherGAUSDOL- GWINNETT

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040129000005 GA Part B Supplier - Clinic/Group Practice 3971406885 Receives reassigned benefits from 220 practitioners
24 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Lawrenceville, GA; Lithonia, GA; Locust Grove, GA; Macon, GA; Marietta, GA; McDonough, GA; Newnan, GA; Peachtree City, GA…
O20100930044973 GA DME Supplier - Physician - Orthopedic/Orthopedic SurgeryDME Supplier - Physician - General PracticeDME Supplier - Independently-Practicing Physical Therapist 3971406885 Practice locations: Lawrenceville, GA

National Provider Directory

National Provider Directory

Locations

900 Circle 75 Pkwy SE
Ste 1700
Atlanta, GA 30339
Phone (770) 953-6929

Ownership & related parties

Other NPIs on the same Medicare enrollment 21

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 21

Other NPIs with the same Medicare PAC ID 19

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

View all 19

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1175472000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1742774400000",
    "number": "1043331978",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3100 INTERSTATE NORTH CIR SE STE 500",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303392296",
            "telephone_number": "770-953-6929",
            "fax_number": "770-953-6972"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "771 OLD NORCROSS RD",
            "address_2": "SUITES 155 / 390",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300464386",
            "telephone_number": "678-205-4261",
            "fax_number": "947-417-7187"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ORTHOATLANTA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-02",
        "last_updated": "2025-03-24",
        "certification_date": "2025-03-24",
        "status": "A",
        "authorized_official_last_name": "OCHAL",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "770-953-6929"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery",
            "state": "GA",
            "license": null,
            "primary": true
        },
        {
            "code": "207XS0106X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery, Hand Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207XS0114X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207XX0004X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery, Foot and Ankle Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207XX0005X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "GA",
            "license": null,
            "primary": false
        },
        {
            "code": "2081P2900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": "GA",
            "license": null,
            "primary": false
        },
        {
            "code": "2251X0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist, Orthopedic",
            "state": "GA",
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DME (ALSO MEDICARE NSC)",
            "identifier": "6285940003",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NSC - DME (#155)",
            "identifier": "6285940012",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "USDOL- GWINNETT",
            "identifier": "346603704",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lawrenceville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.