Individual provider Active NPI

Michael Paul Martinelli, P.A-C

  • Physician Assistant
  • Decatur, GA
National Provider Identifier
1366488017
Registry record updated Oct 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
2024032326 Issued in MO
Practice address
2701 North Decatur Road
Decatur, GA 30033
Phone
(404) 501-1849
NPI assigned
Jun 21, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 004436 GA
Physician Assistant 363A00000X 4436 GA
Physician Assistant 363A00000X 2024032326 MO Primary

Addresses

Primary practice location

2701 North Decatur Road
Decatur, GA 30033

Mailing address

2100 Powell Street
Ste 920
Emeryville, CA 94608-1803
Phone (510) 350-2600

Other identifiers 2

IdentifierTypeStateIssuer
911331220AMedicaidGA
911331220BMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, MO2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20060109000262 GA Practitioner - Physician Assistant 2466475215 Reassigns benefits to 2 organizations
I20240831000456 MO Practitioner - Physician Assistant 2466475215 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cep America LLCGroup PAC ID 6608056171, 995 clinicians

Practice addresses (Care Compare)

2701 N Decatur Rd
Decatur, GA 30033-5918
Phone (510) 851-7493

2801 Dekalb Medical Pkwy
Lithonia, GA 30058-4996
Phone (510) 851-7493

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
87.3 of 100Reported as group
Quality
70.94
Improvement activities
40
Cost
92.94

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4436GAMDSpeech-Language Pathologist
004436GAMDPhysician Assistant
2024032326MOMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Cep America LLC CurrentSince Aug 9, 2024 Accepting new patients
Cep America LLC CurrentSince Apr 13, 2017 Accepting new patients
Cep America LLC CurrentSince Apr 13, 2017 Accepting new patients
First Class Healthcare LLC PastSince Sep 20, 2022 Accepting new patients
Cep America LLC Past Accepting new patients

Locations

2100 Powell St
Ste 400
Emeryville, CA 94608
Phone (510) 350-2638

2100 Powell St
Ste 920
Emeryville, CA 94608
Phone (510) 350-2698

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

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

367 Clear Creek Pkwy
Lavonia, GA 30553
Phone (706) 356-7800

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

1015 Bowles Ave
Fenton, MO 63026
Phone (636) 496-2000

Interoperability endpoints

  • Direct secure messaging: michael.martinelli.1@14358.direct.athenahealth.com
  • Direct secure messaging: mmartinelli520538@direct-ehr-ssmhc.com
  • Direct secure messaging: mmartinelli3473879@direct.trinity-health.org

Organizations & group practices 7

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": "1150848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729814400000",
    "number": "1366488017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 POWELL STREET",
            "address_2": "STE 920",
            "city": "EMERYVILLE",
            "state": "CA",
            "postal_code": "946081803",
            "telephone_number": "510-350-2600",
            "fax_number": "510-879-9100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2701 NORTH DECATUR ROAD",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "30033",
            "telephone_number": "404-501-1849"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTINELLI",
        "first_name": "MICHAEL",
        "middle_name": "PAUL",
        "credential": "P.A-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-21",
        "last_updated": "2024-10-25",
        "certification_date": "2024-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "004436",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "4436",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MO",
            "license": "2024032326",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "911331220A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "911331220B",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Decatur, GA

Sources for this page

Verify at the official NPI Registry.