Individual provider Active NPI

Truc My Thi Dao, PA-C

  • Physician Assistant
  • Austell, GA
National Provider Identifier
1619821394
Registry record updated Feb 20, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
13764 Issued in GA
Practice address
2615 E West Connector Ste 106
Austell, GA 30106-6854
Phone
(770) 941-0010
Fax
(770) 941-0154
NPI assigned
Feb 20, 2026
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 20, 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 13764 GA Primary

Addresses

Primary practice location

2615 E West Connector Ste 106
Austell, GA 30106-6854

Mailing address

2615 E West Connector Ste 106
Austell, GA 30106-6854
Phone (770) 941-0010

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
I20260522001702 GA Practitioner - Physician Assistant 6406326107 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Philadelphia College of Osteopathic Medicine, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1230 Bald Ridge Marina Rd
Suite 400
Cumming, GA 30041-7536

6087 Hannah Way
Tucker, GA 30084-1816

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
13764GAMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Shree Yamuna Maharaniji,PC PastSince Jul 1, 2020 Accepting new patients

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": "1771545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1771545600000",
    "number": "1619821394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2615 E WEST CONNECTOR STE 106",
            "city": "AUSTELL",
            "state": "GA",
            "postal_code": "301066854",
            "telephone_number": "770-941-0010",
            "fax_number": "770-941-0154"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2615 E WEST CONNECTOR STE 106",
            "city": "AUSTELL",
            "state": "GA",
            "postal_code": "301066854",
            "telephone_number": "770-941-0010",
            "fax_number": "770-941-0154"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAO",
        "first_name": "TRUC MY",
        "middle_name": "THI",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-02-20",
        "last_updated": "2026-02-20",
        "certification_date": "2026-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "13764",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Austell, GA

Sources for this page

Verify at the official NPI Registry.