Individual provider Active NPI

Mirela Makarevic

  • Family Nurse Practitioner
  • Dacula, GA
National Provider Identifier
1144055013
Registry record updated Sep 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN260762 Issued in GA
Practice address
3392 Holly Glen Dr
Dacula, GA 30019-6595
Phone
(404) 819-6138
NPI assigned
Sep 3, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 3, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RN260762 GA Primary

Addresses

Primary practice location

3392 Holly Glen Dr
Dacula, GA 30019-6595

Mailing address

3392 Holly Glen Dr
Dacula, GA 30019-6595
Phone (404) 819-6138

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
I20241010003058 GA Practitioner - Nurse Practitioner 9234661612 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Atlanta Oncology Services LLCGroup PAC ID 1850627423, 29 clinicians

Practice addresses (Care Compare)

631 Professional Dr
Suite 450
Lawrenceville, GA 30046-3370
Phone (770) 963-8030

Hospital & facility affiliations

  • Northside Hospital Hospital, Atlanta, GA, CCN 110161
  • Northside Hospital Gwinnett Hospital, Lawrenceville, GA, CCN 110087

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN260762GAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
North Atlanta Oncology Services LLC CurrentSince Oct 7, 2024 Accepting new patients

Locations

2098 Teron Trce
Ste 400
Dacula, GA 30019
Phone (678) 312-6800

631 Professional Dr
Ste 450
Lawrenceville, GA 30046
Phone (770) 963-8030

1000 Johnson Ferry Rd
Sandy Springs, GA 30342
Phone (404) 851-8737

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": "1725321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725321600000",
    "number": "1144055013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3392 HOLLY GLEN DR",
            "city": "DACULA",
            "state": "GA",
            "postal_code": "300196595",
            "telephone_number": "404-819-6138"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3392 HOLLY GLEN DR",
            "city": "DACULA",
            "state": "GA",
            "postal_code": "300196595",
            "telephone_number": "404-819-6138"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAKAREVIC",
        "first_name": "MIRELA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-09-03",
        "last_updated": "2024-09-03",
        "certification_date": "2024-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN260762",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dacula, GA

Sources for this page

Verify at the official NPI Registry.