Damon Robert Denzin, PHYSICIAN ASSISTANT

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

003577 Issued in GA

Practice address

61 Whitcher St NE
Suite 4100
Marietta, GA 30060-1176

Phone

(770) 590-4180

Fax

(770) 590-4187

NPI assigned

Nov 8, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

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

Specialty

Physician Assistant

Education

Emory University School of Medicine, 2000

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Wellstar Medical Group LLCGroup PAC ID 6709065402, 3,059 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Wellstar Kennestone Regional Medical Center Hospital, Marietta, GA, CCN 110035

Merit-based Incentive Payment System (MIPS)

Final score

93.93 of 100Reported as apm

Quality

82.14

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine, Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ddenzin57934@directwellstar.org

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.

• Wellstar Medical Group, LLC

  • Family Medicine Physician
  • Kennesaw, GA
  • NPI 1558664003
  Medicare reassignment Care Compare group
• Kennestone Hospital, Inc.

  • General Acute Care Hospital
  • Marietta, GA
  • NPI 1649248626
  Medicare reassignment
• Kennestone Hospital, Inc

  • Psychiatric Hospital Unit
  • Atlanta, GA
  • NPI 1689361438
  NPD
• Wellstar Medical Group, LLC

  • Multi-Specialty Clinic/Center
  • Marietta, GA
  • NPI 1275992240
  NPD
• Wellstar Medical Group, LLC

  • Family Medicine Physician
  • Canton, GA
  • NPI 1386054278
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Kennestone Hospital, Inc.

  • General Acute Care Hospital
  • Marietta, GA
  • NPI 1649248626
  Care Compare affiliation

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

{
    "created_epoch": "1162944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572998400000",
    "number": "1255401527",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "872 DEVONWOOD TRL NW",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300645440",
            "telephone_number": "678-687-0229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "61 WHITCHER ST NE",
            "address_2": "SUITE 4100",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300601176",
            "telephone_number": "770-590-4180",
            "fax_number": "770-590-4187"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DENZIN",
        "first_name": "DAMON",
        "middle_name": "ROBERT",
        "credential": "PHYSICIAN ASSISTANT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-08",
        "last_updated": "2019-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "003577",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100002309A",
            "state": "GA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ddenzin57934@directwellstar.org",
            "affiliation": "N",
            "address_1": "61 Whitcher St NE",
            "address_2": "Suite 4100",
            "city": "Marietta",
            "state": "GA",
            "country_code": "US",
            "postal_code": "300601176",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Dental Sleep & TMJ Pain Solutions
• Dental Wellness Center of Marietta, LLC
• Georgia J Denton, MSPT, MTC
• Whitney S Denton, M.D.
• Denward Healthy Living Inc
• John Carmen Dercola, PA
• Dermatology and Surgery Specialists of North Atlanta PC
• Dermatopathology Lab of Skin Cancer Specialists, P.C.
• Daksha Desai, BPHARM
• Hardi Desai

• Physician Assistant in Marietta, GA
• Providers in Marietta, GA by specialty
• Physician Assistant in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2019; 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.

Verify at the official NPI Registry.