Individual provider Active NPI

Brandon Hereman, PA

  • Medical Physician Assistant
  • Lawrenceville, GA
National Provider Identifier
1235919390
Registry record updated Oct 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
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

Updated by the provider on Oct 4, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250923002086 GA Practitioner - Physician Assistant 0042715955 Reassigns benefits to 2 organizations

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
Piedmont Orthopedics, LLCGroup PAC ID 4385963172, 191 clinicians

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

OrganizationSpecialtyStatusNew patients
Orthoatlanta, LLC Current Accepting new patients
Orthoatlanta, LLC CurrentSince Sep 6, 2025 Accepting new patients
Orthoatlanta, LLC CurrentSince Sep 6, 2025 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.

Hospital & facility affiliations 1

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": "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

Verify at the official NPI Registry.