Individual provider Active NPI

Angela Tison Dimare, PA-C

  • Surgical Physician Assistant
  • Marietta, GA
National Provider Identifier
1245483486
Registry record updated Jan 31, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
005464 Issued in GA
Practice address
300 Tower Road
Suite 200
Marietta, GA 30060-9403
Phone
(770) 427-5717
Fax
(770) 514-6744
NPI assigned
Oct 31, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 31, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 005464 GA Primary
Physician Assistant 363A00000X 005464 GA

Addresses

Primary practice location

300 Tower Road
Suite 200
Marietta, GA 30060-9403

Mailing address

300 Tower Road
Suite 200
Marietta, GA 30060-9403
Phone (770) 427-5717

Other names 1

  • Angela C. Tison Former name

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
I20081229000572 GA Practitioner - Physician Assistant 3779645734 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of South Alabama College of Medicine, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pinnacle Orthopaedics and Sports Medicine Specialists LLCGroup PAC ID 6204723216, 48 clinicians

Practice addresses (Care Compare)

100 Greystone Power Blvd
Dallas, GA 30157-0908
Phone (678) 453-5717

1121 Johnson Ferry Rd
Suite 200
Marietta, GA 30068-5425
Phone (770) 579-8558

1505 Stone Bridge Pkwy
Suite 200
Woodstock, GA 30189-8255

300 Tower Rd
Suite 200
Marietta, GA 30060-9403

300 Tower Rd NE
Suite 200
Marietta, GA 30060-9403
Phone (770) 427-5717

Hospital & facility affiliations

  • Wellstar Kennestone Regional Medical Center Hospital, Marietta, GA, CCN 110035
  • Wellstar Windy Hill Hospital Long-term care hospital, Marietta, GA, CCN 112007

Merit-based Incentive Payment System (MIPS)

Final score
93.93 of 100Reported as apm
Quality
82.14
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Pinnacle Orthopaedics & Sports Medicine Specialists LLC CurrentSince Nov 16, 2015 Accepting new patients
Pinnacle Orthopaedics & Sports Medicine Specialists LLC Past Accepting new patients

Locations

1668 Mulkey Rd
Ste A
Austell, GA 30106
Phone (770) 944-3303

100 Greystone Power Blvd
Dallas, GA 30157
Phone (678) 453-5717

3747 Roswell Rd
Ste 319
Marietta, GA 30062
Phone (770) 579-8558

300 Tower Rd NE
Ste 101
Marietta, GA 30060
Phone (770) 218-0219

300 Tower Rd NE
Ste 200
Marietta, GA 30060
Phone (770) 427-5717

1505 Stone Bridge Pkwy
Ste 200
Woodstock, GA 30189
Phone (770) 926-6520

Interoperability endpoints

  • Direct secure messaging: angela.dimare.1@15749.direct.athenahealth.com
  • Direct secure messaging: angela.dimare@po.eclinicaldirectplus.com

Organizations & group practices 2

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 2

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": "1225411200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1391126400000",
    "number": "1245483486",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 TOWER ROAD",
            "address_2": "SUITE 200",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300609403",
            "telephone_number": "770-427-5717",
            "fax_number": "770-514-6744"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 TOWER ROAD",
            "address_2": "SUITE 200",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300609403",
            "telephone_number": "770-427-5717",
            "fax_number": "770-514-6744"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIMARE",
        "first_name": "ANGELA",
        "middle_name": "TISON",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-10-31",
        "last_updated": "2014-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "GA",
            "license": "005464",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "005464",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANGELA",
            "last_name": "TISON",
            "middle_name": "C.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Marietta, GA

Sources for this page

Verify at the official NPI Registry.