Brian Palm, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

007095 Issued in GA

Practice address

1000 Medical Center Blvd
Lawrenceville, GA 30046-7694

Phone

(678) 312-3356

NPI assigned

Feb 17, 2014

Last updated

Jul 1, 2015By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• Gwinnett Emergency Specialists Observation Services, LLC

  • Emergency Medicine Physician
  • Lawrenceville, GA
  • NPI 1720373129
  Medicare reassignment
• Gwinnett Emergency Specialists, LLC

  • Emergency Medicine Physician
  • Lawrenceville, GA
  • NPI 1437346467
  Medicare reassignment
• Northside Emergency Associates, LLC

  • Emergency Medicine Physician
  • Sandy Springs, GA
  • NPI 1285686303
  Medicare reassignment

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

{
    "created_epoch": "1392595200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1435708800000",
    "number": "1497179121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 153",
            "city": "WOODSTOCK",
            "state": "GA",
            "postal_code": "301880153"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 MEDICAL CENTER BLVD",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300467694",
            "telephone_number": "678-312-3356"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PALM",
        "first_name": "BRIAN",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-02-17",
        "last_updated": "2015-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "007095",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Soomee Pak, CRNA
• Palacio Trans and Limo Services
• Denisa Palade
• Shivani Palanivel, DO
• Sujith Palleti, MD
• Aleaser Palmer, R.N.
• Ramona Palmer
• Pamela E, Flatow, LCSW, LLC
• Ishan Panchal, DO
• Paravah Home Care LLC

• Physician Assistant in Lawrenceville, GA
• Providers in Lawrenceville, GA by specialty
• Physician Assistant in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.