Individual provider Active NPI

Gary S. Mollica, PAAA

  • Anesthesiologist Assistant
  • Atlanta, GA
National Provider Identifier
1255328381
Registry record updated Feb 4, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiologist AssistantTaxonomy code 367H00000X
License
1897 Issued in GA
Practice address
1000 Johnson Ferry Road
Atlanta, GA 30342
Phone
(770) 645-9181
Fax
(770) 645-8455
NPI assigned
Oct 4, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiologist Assistant 367H00000X 1897 GA Primary

Addresses

Primary practice location

1000 Johnson Ferry Road
Atlanta, GA 30342

Mailing address

3155 N Point Pkwy
Attn: Credentialing Dept, Building F, Suite 100
Alpharetta, GA 30005
Phone (770) 645-9181

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Associate of Arts

State licenses

LicenseStateTypeSpecialty
1897GAMDAnesthesiologist Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Atlanta Surgery Center LTD Past Accepting new patients
Ambulatory Anesthesia of Atlanta, P C Past Accepting new patients

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1128384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1202083200000",
    "number": "1255328381",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3155 N POINT PKWY",
            "address_2": "ATTN: CREDENTIALING DEPT, BUILDING F, SUITE 100",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "30005",
            "telephone_number": "770-645-9181",
            "fax_number": "770-645-8455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 JOHNSON FERRY ROAD",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "30342",
            "telephone_number": "770-645-9181",
            "fax_number": "770-645-8455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOLLICA",
        "first_name": "GARY",
        "middle_name": "S.",
        "credential": "PAAA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-04",
        "last_updated": "2008-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367H00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiologist Assistant",
            "state": "GA",
            "license": "1897",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.