NPIMap

Rolandine Vaughan, PAC

Individual provider Active NPI Physician Assistant · Dacula, GA

NPI 1225284367 · NPPES record last updated Mar 15, 2024

Key facts

NPI
1225284367
Entity type
Individual (NPI type 1)
Primary specialty
Physician Assistant 363A00000X
License
10004230A (IN)
Practice address
1862 Auburn Rd Ste 118-X1
Dacula, GA 30019-1676
Phone
(404) 906-6985
Fax
(678) 302-7377
NPI assigned
Aug 8, 2008
Sex
Female
Sole proprietor
No

Organizations & group practices 24

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.

Medicare Care Compare profile

Specialty
Physician Assistant
Education
Eastern Virginia Medical School, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Southeast Permanente Medical Group (823 clinicians)

Practice addresses (Care Compare)

3495 Piedmont Rd NE
Atlanta, GA 30305-1729
Phone (404) 364-7206

Medicare participation

Medicare fee-for-service enrollment
Enrolled (10 enrollments) in GA, NY, FL, OH, MN, CA, MI, IL, IN
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20110119001330 GA Practitioner - Physician Assistant 0143396333 Reassigns benefits to 4 organizations
I20131001000280 GA Practitioner - Physician Assistant 0143396333 Reassigns benefits to 3 organizations
I20230217002022 NY Practitioner - Physician Assistant 0143396333 Reassigns benefits to 2 organizations
I20230410000884 FL Practitioner - Physician Assistant 0143396333 Reassigns benefits to 1 organization
I20230717002156 OH Practitioner - Physician Assistant 0143396333 Reassigns benefits to 1 organization
I20230929002635 MN Practitioner - Physician Assistant 0143396333
I20231003002002 CA Practitioner - Physician Assistant 0143396333
I20231016003560 MI Practitioner - Physician Assistant 0143396333 Reassigns benefits to 1 organization
I20231020002326 IL Practitioner - Physician Assistant 0143396333 Reassigns benefits to 1 organization
I20240129002818 IN Practitioner - Physician Assistant 0143396333 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
025112NYMDSpecialist
005982GAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Georgia Em-I Medical Services, LLC Physician Assistant Current
since Dec 2, 2013		 Accepting new patients
Treasure Coast Medical Associates Current
since Feb 2, 2026		 Accepting new patients
Treasure Coast Medical Associates Current Accepting new patients
BP Immediate Medical Care, PC Specialist Current
since Feb 2, 2026		 Accepting new patients
The Southeast Permanente Medical Group Physician Assistant Current
since Jan 29, 2026		 Accepting new patients
Hometown Urgent Care of Michigan, PC Current
since Aug 15, 2023		 Accepting new patients
Hometown Urgent Care of Michigan, P.C. Current Accepting new patients
American Current Care PA Current
since May 11, 2015		 Accepting new patients
Hometown Urgent Care of Michigan, P.C. Current
since Aug 15, 2023		 Accepting new patients
American Current Care P.a. Current
since May 11, 2015		 Accepting new patients
Klinic Medical PLLC Past Accepting new patients
Rockland Medical Group, PLLC Past
since Apr 15, 2017		 Accepting new patients
Pharma Holding Inc Past
since Jul 23, 2023		 Accepting new patients
Mount Lassen Emergency Physicians LLC Past Accepting new patients
Lavender Inpatient Services LLC Past Accepting new patients
Wellnow Urgent Care, PC Past Accepting new patients
Maroon Bells Emergency Physicians LLC Past Accepting new patients

Locations

3405 NW Federal Hwy
Jensen Beach, FL 34957
Phone (772) 692-8082

305 NE Park St
Okeechobee, FL 34972
Phone (772) 692-8082

7195 S George Blvd
Sebring, FL 33875
Phone (863) 451-5854

3495 Piedmont Rd NE
Bldg 9
Atlanta, GA 30305
Phone (404) 364-7000

688 Spring St NW
Atlanta, GA 30308
Phone (404) 881-1155

3651 Wheeler Rd
Augusta, GA 30909
Phone (706) 651-3232

5126 Hospital Dr NE
Covington, GA 30014
Phone (770) 385-4340

1700 Medical Way
Snellville, GA 30078
Phone (770) 978-4229

102 Sagamore Pkwy S
Lafayette, IN 47905
Phone (765) 237-3224

1634 Gull Rd
Kalamazoo, MI 49048
Phone (269) 903-2835

3808 14th Ave
Brooklyn, NY 11218
Phone (718) 972-2424

735 Bedford Ave
Brooklyn, NY 11205
Phone (201) 688-2424

7537 31st Ave
Flushing, NY 11370
Phone (929) 447-7513

2 Suffern Ln
Garnerville, NY 10923
Phone (845) 218-0809

6210 Brandt Pike
Huber Heights, OH 45424
Phone (937) 236-8630

Interoperability endpoints

  • Direct secure messaging: rolandine.vaughan@398008301912068.direct.elationemr.com

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 005982 GA
Physician Assistant 363A00000X 0110002860 VA
Physician Assistant 363A00000X 005982 GA
Physician Assistant 363A00000X
Physician Assistant 363A00000X 10004230A IN Yes

Addresses

Primary practice location

1862 Auburn Rd Ste 118-X1
Dacula, GA 30019-1676

Mailing address

2084 Mitford CT
Dacula, GA 30019-2486
Phone (678) 960-8953

Other practice location 1

2084 Mitford Ct
Dacula, GA 30019-2486
Phone (678) 960-8953

Other identifiers

IdentifierTypeStateIssuer
00429217DMedicaidGA

Other providers in Dacula, GA

All providers in Dacula, GA · Physician Assistant in Georgia

Sources for this page

Verify at the official NPI Registry.