Individual provider Active NPI

Alyssa Gattis, PA

  • Physician Assistant
  • Suwanee, GA
National Provider Identifier
1366114290
Registry record updated Dec 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
11649 Issued in GA
Practice address
1300 Peachtree Industrial Blvd Ste 4101
Suwanee, GA 30024-4542
Phone
(770) 831-5525
NPI assigned
Sep 29, 2021
Last updated
Dec 20, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X
Physician Assistant 363A00000X 11649 GA Primary

Addresses

Primary practice location

1300 Peachtree Industrial Blvd Ste 4101
Suwanee, GA 30024-4542

Mailing address

1300 Peachtree Industrial Blvd Ste 4101
Suwanee, GA 30024-4542
Phone (770) 831-5525

Other practice location 1

253 Erin Shores Dr
Sparta, GA 31087-2100
Phone (404) 771-0799

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address agattis178707@nghs.gadirect.net Direct

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
I20231017002179 GA Practitioner - Physician Assistant 3476908039 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
88.16 of 100Reported as group
Quality
85.71
Promoting interoperability
100
Improvement activities
40
Cost
74.81

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Choa Hospital Based, LLC Past Accepting new patients
Children's Orthopaedics of Atlanta P.C. PastSince Mar 1, 2013 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: agattis178707@nghs.gadirect.net

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1632873600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703030400000",
    "number": "1366114290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 PEACHTREE INDUSTRIAL BLVD STE 4101",
            "city": "SUWANEE",
            "state": "GA",
            "postal_code": "300244542",
            "telephone_number": "770-831-5525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 PEACHTREE INDUSTRIAL BLVD STE 4101",
            "city": "SUWANEE",
            "state": "GA",
            "postal_code": "300244542",
            "telephone_number": "770-831-5525"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "253 Erin Shores Dr",
            "address_purpose": "LOCATION",
            "city": "Sparta",
            "state": "GA",
            "postal_code": "310872100",
            "country_code": "US",
            "telephone_number": "404-771-0799",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GATTIS",
        "first_name": "ALYSSA",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-29",
        "last_updated": "2023-12-20",
        "certification_date": "2023-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "11649",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "agattis178707@nghs.gadirect.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1300 Peachtree Industrial Blvd Ste 4101",
            "city": "Suwanee",
            "state": "GA",
            "country_code": "US",
            "postal_code": "300244542",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Suwanee, GA

Sources for this page

Verify at the official NPI Registry.