Individual provider Active NPI

Donald Piestrak

  • Physician Assistant
  • Lagrange, GA
National Provider Identifier
1588093587
Registry record updated Apr 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
1399 Lafayette Pkwy
Lagrange, GA 30241-2572
Phone
(706) 298-4937
Fax
(706) 298-4926
NPI assigned
Nov 11, 2013
Last updated
Apr 9, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2026

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 Primary

Addresses

Primary practice location

1399 Lafayette Pkwy
Lagrange, GA 30241-2572

Mailing address

1698 Vernon Rd
Lagrange, GA 30240-4100
Phone (706) 298-4937

Other practice location 1

1698 Vernon Rd
LaGrange, GA 30240-4100
Phone (706) 298-4937

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
I20140415001331 GA Practitioner - Physician Assistant 8921230467 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hometown Physician Group, LLCGroup PAC ID 1759678824, 7 clinicians

Practice addresses (Care Compare)

1399 Lafayette Pkwy
Lagrange, GA 30241-2572
Phone (706) 298-4937

1698 Vernon Rd
Lagrange, GA 30240-4100
Phone (706) 298-4937

National Provider Directory

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

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1384128000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775692800000",
    "number": "1588093587",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1698 VERNON RD",
            "city": "LAGRANGE",
            "state": "GA",
            "postal_code": "302404100",
            "telephone_number": "706-298-4937"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1399 LAFAYETTE PKWY",
            "city": "LAGRANGE",
            "state": "GA",
            "postal_code": "302412572",
            "telephone_number": "706-298-4937",
            "fax_number": "706-298-4926"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1698 Vernon Rd",
            "address_purpose": "LOCATION",
            "city": "LaGrange",
            "state": "GA",
            "postal_code": "302404100",
            "country_code": "US",
            "telephone_number": "706-298-4937",
            "fax_number": "706-298-4926",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PIESTRAK",
        "first_name": "DONALD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-11-11",
        "last_updated": "2026-04-09",
        "certification_date": "2026-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lagrange, GA

Sources for this page

Verify at the official NPI Registry.