Active NPI
Angela Tison Dimare, PA-C
- Surgical Physician Assistant
- Marietta, GA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgical Physician Assistant
- License
- 005464
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
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 South Alabama College of Medicine, 2008
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
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
- Wellstar Windy Hill Hospital
Merit-based Incentive Payment System (MIPS)
- Final score
- 93.93 of 100
- Quality
- 82.14
- Promoting interoperability
- 100
- Improvement activities
- 40
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pinnacle Orthopaedics & Sports Medicine Specialists LLC | Current | 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
- angela.dimare.1@15749.direct.athenahealth.com
- 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.
-
- Specialist
- Marietta, GA
- NPI 1194815175
-
- Specialist
- Marietta, GA
- NPI 1003367707
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Marietta, GA
- NPI 1649248626
-
- Long Term Care Hospital
- Marietta, GA
- NPI 1700853041
Long-term care hospital
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2014; 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.