Individual provider Active NPI

Nermin Tepic

  • Surgical Physician Assistant
  • Gainesville, GA
National Provider Identifier
1073988853
Registry record updated Feb 2, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
7867 Issued in GA
Practice address
1075 Jesse Jewell Pkwy NE Ste B
Gainesville, GA 30501-3814
Phone
(770) 219-9200
NPI assigned
Dec 5, 2015
Last updated
Feb 2, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 7867 GA Primary

Addresses

Primary practice location

1075 Jesse Jewell Pkwy NE Ste B
Gainesville, GA 30501-3814

Mailing address

1075 Jesse Jewell Pkwy NE Ste B
Gainesville, GA 30501-3814
Phone (770) 219-9200

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
I20160211000040 GA Practitioner - Physician Assistant 4385948306 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
93.93 of 100Reported as apm
Quality
82.14
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
7867GAMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Northeast Georgia Physicians Group Inc CurrentSince Feb 22, 2016 Accepting new patients
Northeast Georgia Surgical Associates PC PastSince Aug 1, 2008 Accepting new patients

Locations

1075 Jesse Jewell Pkwy NE
Ste B
Gainesville, GA 30501
Phone (770) 219-9200

597 S Enota Dr NE
Gainesville, GA 30501
Phone (770) 219-8275

Organizations & group practices 7

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

NPI Registry JSON

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

{
    "created_epoch": "1449273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1454371200000",
    "number": "1073988853",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1075 JESSE JEWELL PKWY NE STE B",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305013814",
            "telephone_number": "770-219-9200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1075 JESSE JEWELL PKWY NE STE B",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305013814",
            "telephone_number": "770-219-9200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TEPIC",
        "first_name": "NERMIN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-12-05",
        "last_updated": "2016-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "GA",
            "license": "7867",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gainesville, GA

Sources for this page

Verify at the official NPI Registry.