Active NPI
Brandon Hereman, PA
- Medical Physician Assistant
- Lawrenceville, GA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- Practice address
- 965 Oakland Rd Ste C
Lawrenceville, GA 30044-3758 - Phone
- (678) 364-2210
- NPI assigned
- Oct 4, 2023
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | Primary |
Addresses
Primary practice location
965 Oakland Rd Ste C
Lawrenceville, GA 30044-3758
Mailing address
750 Avondale Creek Dr Unit 423
Decatur, GA 30032-8418
Phone (407) 443-2808
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- University of Florida College of Medicine
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1800 Howell Mill Rd NW
Suite 200
Atlanta, GA 30318-0917
Phone (404) 352-1015
1968 Peachtree Rd NW
Atlanta, GA 30309-1281
Phone (404) 352-1053
3929 Peachtree Rd NE
Suite 250
Brookhaven, GA 30319-3374
Phone (404) 352-1053
620 Cherokee St NE
Suite 300
Marietta, GA 30060-7202
Phone (770) 635-1812
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Orthoatlanta, LLC | Current | Accepting new patients | |
| Orthoatlanta, LLC | Current | Accepting new patients | |
| Orthoatlanta, LLC | Current | Accepting new patients |
Locations
1800 Howell Mill Rd NW
Ste 200
Atlanta, GA 30318
Phone (404) 352-1015
1265 Highway 54 W
Ste 308
Fayetteville, GA 30214
Phone (678) 216-0771
620 Cherokee St NE
Ste 300
Marietta, GA 30060
Phone (770) 635-1812
Organizations & group practices 4
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.
-
- Orthopaedic Surgery Physician
- Atlanta, GA
- NPI 1114317062
-
- Orthopaedic Surgery Physician
- Newnan, GA
- NPI 1851937114
-
- Orthopaedic Surgery Physician
- Douglasville, GA
- NPI 1033855408
-
- Orthopaedic Surgery Physician
- Evans, GA
- NPI 1679251920
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Atlanta, GA
- NPI 1962461681
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1696377600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1696377600000",
"number": "1235919390",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "750 AVONDALE CREEK DR UNIT 423",
"city": "DECATUR",
"state": "GA",
"postal_code": "300328418",
"telephone_number": "407-443-2808"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "965 OAKLAND RD STE C",
"city": "LAWRENCEVILLE",
"state": "GA",
"postal_code": "300443758",
"telephone_number": "678-364-2210"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HEREMAN",
"first_name": "BRANDON",
"credential": "PA",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2023-10-04",
"last_updated": "2023-10-04",
"certification_date": "2023-10-04",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Lawrenceville, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2023; 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.