Individual provider Active NPI

Jonathan Nguyen

  • Plastic Surgery Physician
  • Atlanta, GA
National Provider Identifier
1558716225
Registry record updated Sep 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
License
82571 Issued in GA
Practice address
550 Peachtree Street, SE
8TH Floor, Suite 4300
Atlanta, GA 30308
Phone
(404) 686-8143
NPI assigned
Apr 29, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Plastic Surgery Physician 208200000X 82571 GA Primary

Addresses

Primary practice location

550 Peachtree Street, SE
8TH Floor, Suite 4300
Atlanta, GA 30308

Mailing address

550 Peachtree Street, SE
8TH Floor, Suite 4300
Atlanta, GA 30308
Phone (404) 686-8143

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211109000102 GA Practitioner - Plastic and Reconstructive SurgeryPractitioner - General Surgery 4284990326 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Plastic and Reconstructive Surgery
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Atlanta Plastic Surgery PCGroup PAC ID 7618961590, 4 clinicians

Practice addresses (Care Compare)

975 Johnson Ferry Nerd
Suite 100
Atlanta, GA 30342-1618
Phone (404) 256-1311

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Mastectomy56
Melanoma (skin cancer) excision11
Removal of tissue1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
82571GAMDPlastic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Atlanta Plastic Surgery PC Plastic Surgery CurrentSince Jan 9, 2024 Accepting new patients
Northside Surgical Professional Services LLC CurrentSince Dec 15, 2022 Accepting new patients

Locations

460 Northside Cherokee Blvd
Ste 430
Canton, GA 30115
Phone (678) 493-2527

1001 Johnson Fy Rd NE
Sandy Springs, GA 30342
Phone (404) 785-2008

975 Johnson Fy Rd NE
Sandy Springs, GA 30342
Phone (404) 256-1311

1000 Johnson Fy Rd NE
Sandy Springs, GA 30342
Phone (404) 851-1000

975 Johnson Fy Rd NE
Ste 100
Sandy Springs, GA 30342
Phone (404) 255-8086

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 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": "1461888000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632787200000",
    "number": "1558716225",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "550 PEACHTREE STREET, SE",
            "address_2": "8TH FLOOR, SUITE 4300",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "30308",
            "telephone_number": "404-686-8143"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 PEACHTREE STREET, SE",
            "address_2": "8TH FLOOR, SUITE 4300",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "30308",
            "telephone_number": "404-686-8143"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "JONATHAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-04-29",
        "last_updated": "2021-09-28",
        "certification_date": "2021-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "GA",
            "license": "82571",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.