NPIMap

Organization Active NPI

Marietta Eye Clinic PA

Doing business as Marietta Eye Surgery at Johns Creek

  • Ophthalmologic Surgery Clinic/Center
  • Suwanee, GA
National Provider Identifier
1225836869
Registry record updated Mar 31, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmologic Surgery Clinic/CenterTaxonomy code 261QS0132X
Legal business name
MARIETTA EYE CLINIC PA
Doing business as
Marietta Eye Surgery at Johns Creek
Practice address
4025 Johns Creek Pkwy Ste 400
Suwanee, GA 30024-5682
Phone
(469) 872-4706
NPI assigned
Mar 7, 2025
Last updated
Mar 31, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2026

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

Authorized official

Name
Collin Lemaistre
Title
Officer/Authorized Official
Phone
(214) 213-0732

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmologic Surgery Clinic/Center 261QS0132X NU Primary

Addresses

Primary practice location

4025 Johns Creek Pkwy Ste 400
Suwanee, GA 30024-5682

Mailing address

4025 Johns Creek Pkwy Ste 400
Suwanee, GA 30024-5682

Other names 1

  • MARIETTA EYE SURGERY AT JOHNS CREEK Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20260209000934 GA Part B Supplier - Ambulatory Surgical Center 0143210427 Practice locations: Suwanee, GA

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Paul Mitchell MD17 organizations share this tax ID, including this one

Other organizations with this tax ID 16

Organizations that report the same tax identification number in the National Provider Directory.

View all 16

Locations

399 Market Place Blvd
Ste 100
Cartersville, GA 30121
Phone (678) 439-2490

949 Joe Frank Harris Pkwy SE
Cartersville, GA 30120
Phone (770) 386-3600

4645 Timber Ridge Dr
Ste 100
Douglasville, GA 30135
Phone (678) 702-3376

47 Highland Pavilion Ct
Ste 101
Hiram, GA 30141

3565 Austell Rd SW
Marietta, GA 30008
Phone (770) 801-0700

3939 Roswell Rd
Ste 100
Marietta, GA 30062
Phone (770) 977-8000

4025 Johns Creek Pkwy
Ste 400
Suwanee, GA 30024

Practitioners & affiliated clinicians

Practitioners 53

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 53

NPI Registry JSON

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

{
    "created_epoch": "1741305600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1774915200000",
    "number": "1225836869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4025 JOHNS CREEK PKWY STE 400",
            "city": "SUWANEE",
            "state": "GA",
            "postal_code": "300245682"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4025 JOHNS CREEK PKWY STE 400",
            "city": "SUWANEE",
            "state": "GA",
            "postal_code": "300245682",
            "telephone_number": "469-872-4706"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARIETTA EYE CLINIC PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-03-07",
        "last_updated": "2026-03-31",
        "certification_date": "2026-03-31",
        "status": "A",
        "authorized_official_last_name": "LEMAISTRE",
        "authorized_official_first_name": "COLLIN",
        "authorized_official_title_or_position": "OFFICER/AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "214-213-0732"
    },
    "taxonomies": [
        {
            "code": "261QS0132X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ophthalmologic Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MARIETTA EYE SURGERY AT JOHNS CREEK",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "MARIETTA EYE SURGERY AT JOHNS CREEK",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Suwanee, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.