Individual provider Active NPI

Celine Nguyen

  • Physician Assistant
  • Lawrenceville, GA
National Provider Identifier
1104791599
Registry record updated Mar 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
13615 Issued in GA
Practice address
850 Lawrenceville Suwanee Rd Ste 101
Lawrenceville, GA 30043-5483
Phone
(770) 963-2451
Fax
(770) 962-0017
NPI assigned
Oct 7, 2025
Last updated
Mar 9, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 9, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 13615 GA Primary

Addresses

Primary practice location

850 Lawrenceville Suwanee Rd Ste 101
Lawrenceville, GA 30043-5483

Mailing address

1930 Brannan Rd
McDonough, GA 30253-4310
Phone (678) 284-4040

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
I20260317001108 GA Practitioner - Physician Assistant 6204319346 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Georgia Urology, PAGroup PAC ID 8921094376, 99 clinicians

Practice addresses (Care Compare)

850 Lawrenceville Suwanee Rd
Suite 101
Lawrenceville, GA 30043-5483
Phone (770) 963-2451

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
13615GAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Urological Professional Services, LLC CurrentSince Mar 23, 2026 Accepting new patients
Georgia Urology PA CurrentSince Mar 23, 2026 Accepting new patients
Georgia Urology, PA CurrentSince Mar 23, 2026 Accepting new patients

Locations

850 Lawrenceville Suwanee Rd
Ste 101
Lawrenceville, GA 30043
Phone (770) 963-2451

1930 Brannan Rd
McDonough, GA 30253
Phone (678) 284-4040

Organizations & group practices 3

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.

Hospital & facility affiliations 1

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": "1759795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773014400000",
    "number": "1104791599",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1930 BRANNAN RD",
            "city": "MCDONOUGH",
            "state": "GA",
            "postal_code": "302534310",
            "telephone_number": "678-284-4040",
            "fax_number": "678-284-4076"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "850 LAWRENCEVILLE SUWANEE RD STE 101",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300435483",
            "telephone_number": "770-963-2451",
            "fax_number": "770-962-0017"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "CELINE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-10-07",
        "last_updated": "2026-03-09",
        "certification_date": "2026-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "13615",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lawrenceville, GA

Sources for this page

Verify at the official NPI Registry.