Individual provider Active NPI

Laura L. Bayani, PA-C

  • Physician Assistant
  • Marietta, GA
National Provider Identifier
1578819918
Registry record updated Aug 2, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5990 Issued in GA
Practice address
1605 Roberta Dr SW
Marietta, GA 30008-3855
Phone
(770) 419-3120
NPI assigned
Aug 2, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2012

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 5990 GA Primary

Addresses

Primary practice location

1605 Roberta Dr SW
Marietta, GA 30008-3855

Mailing address

1605 Roberta Dr SW
Marietta, GA 30008-3855
Phone (770) 419-3120

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
I20120921000008 GA Practitioner - Physician Assistant 3779731401 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5990GAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Summit Medical Group, Inc Physician Assistant Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: laura.bayani.1@20065.direct.athenahealth.com

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1343865600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1343865600000",
    "number": "1578819918",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1605 ROBERTA DR SW",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300083855",
            "telephone_number": "770-419-3120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1605 ROBERTA DR SW",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300083855",
            "telephone_number": "770-419-3120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAYANI",
        "first_name": "LAURA",
        "middle_name": "L.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-08-02",
        "last_updated": "2012-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "5990",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marietta, GA

Sources for this page

Verify at the official NPI Registry.