Individual provider Active NPI

John A. Zelisko, MD

  • Anesthesiology Physician
  • Greensboro, GA
National Provider Identifier
1124087168
Registry record updated Sep 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
82717 Issued in GA
Practice address
1000 Cowles Clinc Way
Greensboro, GA 30642-5285
Phone
(706) 454-0159
NPI assigned
Mar 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 21408 SC
Anesthesiology Physician 207L00000X 82717 GA Primary

Addresses

Primary practice location

1000 Cowles Clinc Way
Greensboro, GA 30642-5285

Mailing address

1070 Maple Ridge Way
Greensboro, GA 30642-3933
Phone (803) 312-2572

Other practice location 1

156 Foster Dr Spc C
McDonough, GA 30253-5346
Phone (770) 968-9978

Other identifiers 1

IdentifierTypeStateIssuer
T54884MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC, GA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20111214001036 SC Practitioner - Anesthesiology 1254505480
I20190828003036 GA Practitioner - Anesthesiology 1254505480 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Northwestern University Feinberg Medical School, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Atlanta Anesthesia Professionals, LLCGroup PAC ID 5496134348, 543 clinicians

Practice addresses (Care Compare)

1000 Cowles Clinc Way
Greensboro, GA 30642-5285

1000 Johnson Ferry Rd
Atlanta, GA 30342-1606
Phone (404) 851-8000

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

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
82717GAMDAnesthesiology Physician
21408SCMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
North Atlanta Anesthesia Professionals, LLC Anesthesiology CurrentSince Oct 20, 2022 Accepting new patients
North Atlanta Professional Services LLC CurrentSince Sep 15, 2022 Accepting new patients
American Anesthesiology Associates of Georgia, LLC Anesthesiology CurrentSince Jul 1, 2019 Accepting new patients
Capitol Anesthesiology, PC Anesthesiology CurrentSince Dec 1, 2019 Accepting new patients
Pain Management, LLC Past Accepting new patients

Locations

2701 N Decatur Rd
Decatur, GA 30033
Phone (404) 501-1000

1336 Highway 54 W
Bldg 400
Fayetteville, GA 30214
Phone (678) 251-0200

1000 Cowles Clinic Way
Greensboro, GA 30642
Phone (706) 454-0111

1000 Medical Center Blvd
Lawrenceville, GA 30046
Phone (678) 312-3356

888 Pine St
Macon, GA 31201
Phone (478) 751-0527

777 Hemlock St
Macon, GA 31201
Phone (478) 474-5600

1014 Forsyth St
Macon, GA 31201
Phone (478) 633-5800

156 Foster Dr
Spc C
McDonough, GA 30253

6649 Lake Dr
Morrow, GA 30260

1000 Corporate Center Dr
Ste 180
Morrow, GA 30260
Phone (770) 968-8888

1000 Johnson Fy Rd NE
Sandy Springs, GA 30342
Phone (404) 851-1000

800 Mount Vernon Hwy NE
Ste 100
Sandy Springs, GA 30328
Phone (404) 237-1770

180 N Park Trl
#200
Stockbridge, GA 30281
Phone (678) 565-1806

Organizations & group practices 5

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": "1142812800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663200000000",
    "number": "1124087168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1070 MAPLE RIDGE WAY",
            "city": "GREENSBORO",
            "state": "GA",
            "postal_code": "306423933",
            "telephone_number": "803-312-2572",
            "fax_number": "803-765-1732"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 COWLES CLINC WAY",
            "city": "GREENSBORO",
            "state": "GA",
            "postal_code": "306425285",
            "telephone_number": "706-454-0159"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "156 Foster Dr Spc C",
            "address_purpose": "LOCATION",
            "city": "McDonough",
            "state": "GA",
            "postal_code": "302535346",
            "country_code": "US",
            "telephone_number": "770-968-9978",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ZELISKO",
        "first_name": "JOHN",
        "middle_name": "A.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-20",
        "last_updated": "2022-09-15",
        "certification_date": "2022-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "SC",
            "license": "21408",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "GA",
            "license": "82717",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "T54884",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greensboro, GA

Sources for this page

Verify at the official NPI Registry.