Piedmont Ear Nose &Throat Associates PC

Organization Active NPI Otolaryngology/Facial Plastic Surgery Physician · Atlanta, GA

NPI 1245305879 · NPPES record last updated Dec 16, 2024

Key facts

NPI
1245305879
Entity type
Organization (NPI type 2)
Primary specialty
Otolaryngology/Facial Plastic Surgery Physician 207YX0905X
Legal business name
PIEDMONT EAR NOSE &THROAT ASSOCIATES PC
Practice address
1720 Peachtree Street
Suite 200
Atlanta, GA 30309-1605
Phone
(404) 351-5045
Fax
(404) 351-0883
NPI assigned
Nov 21, 2006
Organization subpart
No

Authorized official

Name
Mrs. Tatiana Sycheva-Johnson
Title
Billing Manager
Phone
(470) 563-6468

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners 26

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 26

Laboratory certificates & supplier records

Name & address match These CMS records do not include an NPI. They are shown here because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
11D1100174Piedmont Ear Nose Throat and Allergy
1720 Peachtree Street Suite 200, Atlanta, GA 30309
Certificate of waiverMay 31, 2027

Medicare participation

Medicare fee-for-service enrollment
Enrolled in GA

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20050104000298 GA Part B Supplier - Clinic/Group Practice 8527024124 Receives reassigned benefits from 19 practitioners
Practice locations: Atlanta, GA

National Provider Directory

Locations

35 Collier Rd NW
Ste 455
Atlanta, GA 30309
Phone (248) 563-3883

1720 Peachtree St NW
Ste 200
Atlanta, GA 30309
Phone (404) 351-5045

5445 Meridian Mark Rd
Ste 125
Sandy Springs, GA 30342
Phone (404) 351-5045

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology/Facial Plastic Surgery Physician
Group: 193400000X SINGLE SPECIALTY GROUP
207YX0905X Yes

Addresses

Primary practice location

1720 Peachtree Street
Suite 200
Atlanta, GA 30309-1605

Mailing address

1720 Peachtree Street
Suite 200
Atlanta, GA 30309-1605
Phone (404) 351-5045

Other providers in Atlanta, GA

All providers in Atlanta, GA · Otolaryngology/Facial Plastic Surgery Physician in Georgia

Sources for this page

Verify at the official NPI Registry.