Individual provider Active NPI

Alvin I. Rosenthal, M.D.

  • Surgery of the Hand (Plastic Surgery) Physician
  • Lawrenceville, GA
National Provider Identifier
1134154016
Registry record updated Dec 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery of the Hand (Plastic Surgery) PhysicianTaxonomy code 2082S0105X
License
39926 Issued in GA
Practice address
575 Professional Dr Ste 285
Lawrenceville, GA 30046-3355
Phone
(770) 682-3375
Fax
(770) 682-3387
NPI assigned
Jul 11, 2006
Last updated
Dec 12, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 12, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery of the Hand (Plastic Surgery) Physician 2082S0105X 39926 GA Primary

Addresses

Primary practice location

575 Professional Dr Ste 285
Lawrenceville, GA 30046-3355

Mailing address

575 Professional Dr Ste 285
Lawrenceville, GA 30046-3355
Phone (770) 682-3375

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
I20100831000172 GA Practitioner - Plastic and Reconstructive SurgeryPractitioner - Hand Surgery 2163546912 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Plastic and Reconstructive SurgeryAlso: Hand Surgery
Education
University of Missouri, Columbia School of Medicine, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Physiotherapy Associates IncGroup PAC ID 3577470442, shared by 50 NPIs, 1,432 clinicians

Practice addresses (Care Compare)

3605 Braselton Hwy
Suite 101
Dacula, GA 30019-4666
Phone (770) 904-0772

500 Medical Ctr Blvd
Suite 150
Lawrenceville, GA 30046

575 Professional Dr
Suite 285
Lawrenceville, GA 30046-3300

575 Professional Dr
Suite 285
Lawrenceville, GA 30046-3355
Phone (770) 682-3375

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision16

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
39926GAMDSurgery of the Hand (Plastic Surgery) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Plastic Surgery of Gwinnett PC CurrentSince Jun 12, 1995 Accepting new patients

Locations

500 Medical Center Blvd
Ste 150
Lawrenceville, GA 30046
Phone (770) 682-3375

575 Professional Dr
Ste 285
Lawrenceville, GA 30046
Phone (678) 894-4147

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1152576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670803200000",
    "number": "1134154016",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "575 PROFESSIONAL DR STE 285",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300463355",
            "telephone_number": "770-682-3375",
            "fax_number": "770-682-3387"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "575 PROFESSIONAL DR STE 285",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300463355",
            "telephone_number": "770-682-3375",
            "fax_number": "770-682-3387"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSENTHAL",
        "first_name": "ALVIN",
        "middle_name": "I.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-11",
        "last_updated": "2022-12-12",
        "certification_date": "2022-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2082S0105X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery, Surgery of the Hand",
            "state": "GA",
            "license": "39926",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lawrenceville, GA

Sources for this page

Verify at the official NPI Registry.