Active NPI
Orthoatlanta, LLC
- Orthopaedic Surgery Physician
- Lawrenceville, GA
National Provider Identifier
1043331978
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthopaedic Surgery Physician
- 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
- Last updated
- Mar 24, 2025
- Organization subpart
- No
NPPES NPI Registry
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | GA | ||
| Orthopaedic Surgery Physician | 207X00000X | GA | Primary | |
| Orthopaedic Hand Surgery Physician | 207XS0106X | |||
| Adult Reconstructive Orthopaedic Surgery Physician | 207XS0114X | |||
| Orthopaedic Foot and Ankle Surgery Physician | 207XX0004X | |||
| Sports Medicine (Orthopaedic Surgery) Physician | 207XX0005X | GA | ||
| Pain Medicine (Physical Medicine & Rehabilitation) Physician | 2081P2900X | GA | ||
| Orthopedic Physical Therapist | 2251X0800X | 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 6285940003 | Other | GA | DME (ALSO MEDICARE NSC) |
| 6285940012 | Other | GA | NSC - DME (#155) |
| 346603704 | Other | GA | USDOL- GWINNETT |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in GA
Enrollment records 2
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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 Surgery | 3971406885 | Practice locations: Lawrenceville, GA |
Other NPIs with the same Medicare PAC ID 19
NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).
Other NPIs on the same Medicare enrollment 21
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
National Provider Directory
National Provider DirectoryNPI 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": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "GA",
"license": null,
"primary": false
},
{
"code": "207X00000X",
"taxonomy_group": "",
"desc": "Orthopaedic Surgery",
"state": "GA",
"license": null,
"primary": true
},
{
"code": "207XS0106X",
"taxonomy_group": "",
"desc": "Orthopaedic Surgery, Hand Surgery",
"state": null,
"license": null,
"primary": false
},
{
"code": "207XS0114X",
"taxonomy_group": "",
"desc": "Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery",
"state": null,
"license": null,
"primary": false
},
{
"code": "207XX0004X",
"taxonomy_group": "",
"desc": "Orthopaedic Surgery, Foot and Ankle Surgery",
"state": null,
"license": null,
"primary": false
},
{
"code": "207XX0005X",
"taxonomy_group": "",
"desc": "Orthopaedic Surgery, Sports Medicine",
"state": "GA",
"license": null,
"primary": false
},
{
"code": "2081P2900X",
"taxonomy_group": "",
"desc": "Physical Medicine & Rehabilitation, Pain Medicine",
"state": "GA",
"license": null,
"primary": false
},
{
"code": "2251X0800X",
"taxonomy_group": "",
"desc": "Physical Therapist, Orthopedic",
"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.