Individual provider Active NPI

Michelle Gorzelnik, PA

  • Physician Assistant
  • Austell, GA
National Provider Identifier
1427365634
Registry record updated Feb 27, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
3820 Medical Park Dr
Austell, GA 30106-1110
Phone
(770) 948-6041
Fax
(770) 948-7994
NPI assigned
Sep 9, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

3820 Medical Park Dr
Austell, GA 30106-1110

Mailing address

3820 Medical Park Dr
Austell, GA 30106-1110
Phone (770) 948-6041

Other names 1

  • Michelle Mahonuy Former name

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
I20110527000102 GA Practitioner - Physician Assistant 1254365703 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Piedmont Specialty Hospital Billing LLCGroup PAC ID 4183986490, 252 clinicians

Practice addresses (Care Compare)

1133 Eagles Landing Pkwy
Stockbridge, GA 30281-5085
Phone (678) 604-1000

1968 Peachtree Rd NW
Atlanta, GA 30309-1281
Phone (404) 605-5000

745 Poplar Rd
Newnan, GA 30265-1618
Phone (770) 400-1000

Hospital & facility affiliations

  • Piedmont Hospital, Inc Hospital, Atlanta, GA, CCN 110083
  • Piedmont Newnan Hospital, Inc Hospital, Newnan, GA, CCN 110229

National Provider Directory

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

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 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": "1283990400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1519689600000",
    "number": "1427365634",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3820 MEDICAL PARK DR",
            "city": "AUSTELL",
            "state": "GA",
            "postal_code": "301061110",
            "telephone_number": "770-948-6041",
            "fax_number": "770-948-7994"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3820 MEDICAL PARK DR",
            "city": "AUSTELL",
            "state": "GA",
            "postal_code": "301061110",
            "telephone_number": "770-948-6041",
            "fax_number": "770-948-7994"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORZELNIK",
        "first_name": "MICHELLE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-09-09",
        "last_updated": "2018-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MICHELLE",
            "last_name": "MAHONUY",
            "credential": "PA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Austell, GA

Sources for this page

Verify at the official NPI Registry.