Individual provider Active NPI

Marc E Hinckley, PAAA

  • Anesthesiologist Assistant
  • Decatur, GA
National Provider Identifier
1346405453
Registry record updated Apr 10, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiologist AssistantTaxonomy code 367H00000X
License
005380 Issued in GA
Practice address
2701 N. Decatur Rd
Decatur, GA 30033-0000
Phone
(678) 514-1991
Fax
(678) 514-1992
NPI assigned
Jul 29, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiologist Assistant 367H00000X
Anesthesiologist Assistant 367H00000X 005380 GA Primary

Addresses

Primary practice location

2701 N. Decatur Rd
Decatur, GA 30033-0000

Mailing address

PO Box 551420
Fort Lauderdale, FL 33355-1420
Phone (800) 243-3839

Other identifiers 1

IdentifierTypeStateIssuer
560784679AMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081027000256 GA Practitioner - Anesthesiology Assistant 2567520141 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology Assistant
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Atlanta Anesthesia Professionals, LLCGroup PAC ID 5496134348, 543 clinicians

Practice addresses (Care Compare)

1000 Johnson Ferry Rd
Atlanta, GA 30342-1606
Phone (404) 851-8000

Hospital & facility affiliations

  • Northside Hospital Hospital, Atlanta, GA, CCN 110161
  • Northside Hospital Forsyth Hospital, Cumming, GA, CCN 110005

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
005380GAMDAnesthesiologist Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
North Atlanta Anesthesia Professionals, LLC CurrentSince Sep 1, 2022 Accepting new patients
Piedmont Anesthesia Associates, L.L.C CurrentSince Feb 11, 2017 Accepting new patients
American Anesthesiology Associates of Georgia, LLC CurrentSince Dec 1, 2012 Accepting new patients
Dekalb Anesthesia Associates, P a Past Accepting new patients

Locations

1984 Peachtree Rd NW
Ste 515
Atlanta, GA 30309
Phone (404) 351-1754

1968 Ptree Rd NW
Atlanta, GA 30309
Phone (404) 605-2222

2701 N Decatur Rd
Decatur, GA 30033
Phone (404) 501-1000

1000 Medical Center Blvd
Lawrenceville, GA 30046
Phone (678) 312-3356

1000 Johnson Ferry Rd
Sandy Springs, GA 30342
Phone (404) 851-8737

2171 W Park Ct
Ste A
Stone Mtn, GA 30087
Phone (678) 514-1991

2801 DeKalb Medical Pkwy
Stonecrest, GA 30058
Phone (404) 501-5374

Organizations & group practices 4

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": "1217289600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1365552000000",
    "number": "1346405453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 551420",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333551420",
            "telephone_number": "800-243-3839",
            "fax_number": "954-839-2569"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2701 N. DECATUR RD",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300330000",
            "telephone_number": "678-514-1991",
            "fax_number": "678-514-1992"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HINCKLEY",
        "first_name": "MARC",
        "middle_name": "E",
        "credential": "PAAA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-07-29",
        "last_updated": "2013-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367H00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiologist Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "367H00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiologist Assistant",
            "state": "GA",
            "license": "005380",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "560784679A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Decatur, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.