Antolin Moronta, PHYSICIAN ASSISTANT

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

2034-P.A Issued in PR

Practice address

5955 Jimmy Carter Blvd Ste 100
Norcross, GA 30071-4608

Phone

(770) 559-3555

Fax

(770) 559-3593

NPI assigned

Jan 18, 2024

Last updated

Jan 19, 2024By 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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Grupo Medico de Georgia, LLC

  • Family Medicine Physician
  • Norcross, GA
  • NPI 1639574890
  NPD

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

{
    "created_epoch": "1705536000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705622400000",
    "number": "1518728427",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5955 JIMMY CARTER BLVD STE 100",
            "city": "NORCROSS",
            "state": "GA",
            "postal_code": "300714608",
            "telephone_number": "770-559-3555",
            "fax_number": "770-559-3593"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5955 JIMMY CARTER BLVD STE 100",
            "city": "NORCROSS",
            "state": "GA",
            "postal_code": "300714608",
            "telephone_number": "770-559-3555",
            "fax_number": "770-559-3593"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORONTA",
        "first_name": "ANTOLIN",
        "credential": "PHYSICIAN ASSISTANT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-01-18",
        "last_updated": "2024-01-19",
        "certification_date": "2024-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "PR",
            "license": "2034-P.A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rosalinda Morales, LCSW
• Paola Natalia Moreira, DC
• Jesse Bion Moreland, DDS
• Morning Chiropractic
• Morningstar EMS LLC
• Carly Morris, M.A.
• Flora Jean Morris
• Melissa Elizabeth Mosby Johnson
• Janeicea Mosley
• Madison Moss

• Medical Physician Assistant in Norcross, GA
• Providers in Norcross, GA by specialty
• Medical Physician Assistant in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.