Individual provider Active NPI

Maria Vetrano, PA

  • Physician Assistant
  • Braselton, GA
National Provider Identifier
1528803434
Registry record updated Nov 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
12448 Issued in GA
Practice address
1400 River PL
Braselton, GA 30517-5600
Phone
(770) 534-2020
NPI assigned
Jul 1, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 12, 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 12448 GA Primary

Addresses

Primary practice location

1400 River PL
Braselton, GA 30517-5600

Mailing address

PO Box 742616
Atlanta, GA 30374-2616
Phone (770) 219-8420

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mvetrano203018@nghs.gadirect.net Direct

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
I20241111002725 GA Practitioner - Physician Assistant 7719411917 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
Georgia Heart Institute LLCGroup PAC ID 4183848062, 127 clinicians

Practice addresses (Care Compare)

1400 River PL
Braselton, GA 30517-5600
Phone (770) 848-8000

1404 River PL
Suite 501
Braselton, GA 30517-5600
Phone (770) 534-2020

200 S Enota Dr NE
Gainesville, GA 30501-3466
Phone (770) 534-2020

316 N Broad St
Winder, GA 30680-2150
Phone (770) 867-3400

743 Spring St NE
Gainesville, GA 30501-3715
Phone (770) 534-2020

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Northeast Georgia Heart Center Current Accepting new patients
Indiana University Health Southern Indiana Physicians, LLC Physician Assistant PastSince Jul 1, 2024 Accepting new patients

Locations

200 S Enota Dr NE
Ste 200
Gainesville, GA 30501
Phone (770) 534-0991

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 1

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": "1719792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731369600000",
    "number": "1528803434",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 742616",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303742616",
            "telephone_number": "770-219-8420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 RIVER PL",
            "city": "BRASELTON",
            "state": "GA",
            "postal_code": "305175600",
            "telephone_number": "770-534-2020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VETRANO",
        "first_name": "MARIA",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-07-01",
        "last_updated": "2024-11-12",
        "certification_date": "2024-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "12448",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mvetrano203018@nghs.gadirect.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1400 River Pl",
            "city": "Braselton",
            "state": "GA",
            "country_code": "US",
            "postal_code": "305175600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Braselton, GA

Sources for this page

Verify at the official NPI Registry.