Individual provider Active NPI

Tik Pau, M.D.

  • Family Medicine Physician
  • Lawrenceville, GA
National Provider Identifier
1114347580
Registry record updated Sep 15, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
6755 Issued in GA
Practice address
665 Duluth Hwy Ste 501
Lawrenceville, GA 30046-8709
Phone
(678) 312-0400
Fax
(678) 312-0423
NPI assigned
Apr 23, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 6755 GA Primary

Addresses

Primary practice location

665 Duluth Hwy Ste 501
Lawrenceville, GA 30046-8709

Mailing address

665 Duluth Hwy Ste 501
Lawrenceville, GA 30046-8709
Phone (678) 312-0400

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address tik.paumd.p2@direct.gmg.nextgenshare.com Direct

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170816001947 GA Practitioner - Family Practice 2668788514 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Gwinnett Physician Group, LLCGroup PAC ID 9133211139, 112 clinicians

Practice addresses (Care Compare)

1000 Medical Ctr Blvd
Lawrenceville, GA 30046-7694
Phone (678) 312-4321

1120 Peachtree Industrial Blvd
Suite 208
Suwanee, GA 30024-2013
Phone (770) 963-2969

Hospital & facility affiliations

  • Northside Hospital Gwinnett Hospital, Lawrenceville, GA, CCN 110087
  • Northside Hospital Forsyth Hospital, Cumming, GA, CCN 110005

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
6755GAMDFamily Medicine Physician

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": "1398211200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600128000000",
    "number": "1114347580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "665 DULUTH HWY STE 501",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300468709",
            "telephone_number": "678-312-0400",
            "fax_number": "678-312-0423"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "665 DULUTH HWY STE 501",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300468709",
            "telephone_number": "678-312-0400",
            "fax_number": "678-312-0423"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAU",
        "first_name": "TIK",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-23",
        "last_updated": "2020-09-15",
        "certification_date": "2020-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "6755",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tik.paumd.p2@direct.gmg.nextgenshare.com",
            "affiliation": "N",
            "endpointDescription": "Direct Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Direct Edge",
            "address_1": "665 Duluth Hwy Ste 501",
            "city": "Lawrenceville",
            "state": "GA",
            "country_code": "US",
            "postal_code": "300468709",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Lawrenceville, GA

Sources for this page

Verify at the official NPI Registry.