Justin Mukhalian, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

12397 Issued in GA

Practice address

30 Satellite Dr Ste 200
Winder, GA 30680-6211

Phone

(770) 586-0300

NPI assigned

Jan 9, 2023

Last updated

Oct 25, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 2

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

Specialty

Physician Assistant

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Pulmonary and Sleep Specialists of Piedmont NortheastGroup PAC ID 5698209096, 18 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Piedmont Eastside Medical Center Hospital, Snellville, GA, CCN 110192

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/JADJAA

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.

• Pulmonary and Sleep Specialists of Piedmont Northeast

  • Pulmonary Disease Physician
  • Dacula, GA
  • NPI 1922844570
  Medicare reassignment Care Compare group NPD
• Northeast Georgia Physicians Group Inc

  • Family Medicine Physician
  • Gainesville, GA
  • NPI 1891745212

  Physician Assistant

  Medicare reassignment NPD
• Pulmonary and Sleep Specialists of Northeast Georgia, PC

  dba Pulmonary and Sleep Medicine Center of Winder

  • Pulmonary Disease Physician
  • Winder, GA
  • NPI 1194048561
  Medicare reassignment NPD
• Sleep Telehealth

  • Sleep Medicine (Internal Medicine) Physician
  • Dacula, GA
  • NPI 1114782190
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Eastside Medical Center, LLC

  dba Piedmont Eastside Medical Center

  • General Acute Care Hospital
  • Snellville, GA
  • NPI 1467406132
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1673222400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729814400000",
    "number": "1194439778",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 SATELLITE DR STE 200",
            "city": "WINDER",
            "state": "GA",
            "postal_code": "306806211",
            "telephone_number": "770-586-0300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 SATELLITE DR STE 200",
            "city": "WINDER",
            "state": "GA",
            "postal_code": "306806211",
            "telephone_number": "770-586-0300"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3261 W State Rd",
            "address_purpose": "LOCATION",
            "city": "Saint Bonaventure",
            "state": "NY",
            "postal_code": "147789800",
            "country_code": "US",
            "telephone_number": "716-375-7890",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MUKHALIAN",
        "first_name": "JUSTIN",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-01-09",
        "last_updated": "2024-10-25",
        "certification_date": "2024-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "12397",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jmukhalian198109@nghs.gadirect.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "30 Satellite Dr Ste 200",
            "city": "Winder",
            "state": "GA",
            "country_code": "US",
            "postal_code": "306806211",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mukhalja22@bonaventure.edu",
            "affiliation": "N",
            "endpointDescription": "e-mail",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "3261 W State Rd",
            "city": "Saint Bonaventure",
            "state": "NY",
            "country_code": "US",
            "postal_code": "147789800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Nephron Corporation (Barrow County Dialysis Center)
• Timothy Brian Neville, LPC
• Ashley Nichole Newman, ED.D., CPT, CNC, FWS

• Physician Assistant in Winder, GA
• Providers in Winder, GA by specialty
• Physician Assistant in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.