Plastic Surgery of Gwinnett PC

Primary specialty

SpecialistTaxonomy code 174400000X

License

039926 Issued in GA

Legal business name

PLASTIC SURGERY OF GWINNETT PC

Practice address

575 Professional Dr Ste 285
Lawrenceville, GA 30046-3355

Phone

(770) 682-3375

Fax

(770) 682-3387

NPI assigned

Sep 28, 2012

Organization subpart

No

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

Authorized official

Name

Dr. Alvin I Rosenthal, MDNPI 1134154016

Title

President

Phone

(770) 682-3375

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Alvin I. Rosenthal, M.D.

  • Surgery of the Hand (Plastic Surgery) Physician
  • Lawrenceville, GA
  • NPI 1134154016
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1348790400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1706572800000",
    "number": "1386995470",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "575 PROFESSIONAL DR STE 285",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300463355",
            "telephone_number": "770-682-3375",
            "fax_number": "770-682-3387"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "575 PROFESSIONAL DR STE 285",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300463355",
            "telephone_number": "770-682-3375",
            "fax_number": "770-682-3387"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PLASTIC SURGERY OF GWINNETT PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-09-28",
        "last_updated": "2024-01-30",
        "certification_date": "2024-01-30",
        "status": "A",
        "authorized_official_last_name": "ROSENTHAL",
        "authorized_official_first_name": "ALVIN",
        "authorized_official_middle_name": "I",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "770-682-3375",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "GA",
            "license": "039926",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "40BBBBD",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Asia Marie Pittman, APC
• Cynthia Pittman, RN
• Lakisha Detral Pitts-Donaldson, LMSW
• John E Pitts, MD
• Kasey Cathryn Payne Pitts, CNM
• Christian Podaca, RN
• Archna Poddar, M.D.
• Satish B Poddar, M.D.
• Shashi Poddar, MD
• Jessica Podlaski

• Specialist in Lawrenceville, GA
• Providers in Lawrenceville, GA by specialty
• Specialist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.