Individual provider Active NPI

Kevin Barreto

  • Physician Assistant
  • Brookhaven, GA
National Provider Identifier
1487336236
Registry record updated Dec 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
3930 Peachtree Rd NE Apt 432
Brookhaven, GA 30319-3798
Phone
(407) 491-4921
NPI assigned
Aug 2, 2023
Last updated
Dec 30, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 30, 2024

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 GA Primary

Addresses

Primary practice location

3930 Peachtree Rd NE Apt 432
Brookhaven, GA 30319-3798

Mailing address

4529 Red Lion PL
Lawrenceville, GA 30044-8200
Phone (407) 491-4921

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
I20250418001242 GA Practitioner - Physician Assistant 8921523283 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Emory Clinic IncGroup PAC ID 8820901408, 3,507 clinicians
Esop Rehabilitation LLCGroup PAC ID 9739305749, shared by 9 NPIs, 224 clinicians

Practice addresses (Care Compare)

1365 Clifton Rd NE
Atlanta, GA 30322-1013
Phone (404) 778-7525

1699 Hwy 124 N
Suite 100
Snellville, GA 30078-7921
Phone (678) 218-6702

875 Flat Shoals Rd SE
Suite 150
Conyers, GA 30094-6640
Phone (770) 785-7669

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
The Emory Clinic Inc CurrentSince Apr 16, 2025 Accepting new patients

Locations

1365 Clifton Rd NE
Atlanta, GA 30322
Phone (404) 778-7525

2201 Henderson Mill Rd NE
Ste 160
Atlanta, GA 30345
Phone (404) 251-2193

Interoperability endpoints

  • Direct secure messaging: kbarreto1088420@direct.emory.org

Organizations & group practices 1

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.

Hospital & facility affiliations 4

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": "1690934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735516800000",
    "number": "1487336236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4529 RED LION PL",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300448200",
            "telephone_number": "407-491-4921"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3930 PEACHTREE RD NE APT 432",
            "city": "BROOKHAVEN",
            "state": "GA",
            "postal_code": "303193798",
            "telephone_number": "407-491-4921"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARRETO",
        "first_name": "KEVIN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-08-02",
        "last_updated": "2024-12-30",
        "certification_date": "2024-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brookhaven, GA

Sources for this page

Verify at the official NPI Registry.