Individual provider Active NPI

Seth A Yellin, MD

  • Plastic and Reconstructive Surgery Physician
  • Marietta, GA
National Provider Identifier
1619933249
Registry record updated Jan 26, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic and Reconstructive Surgery PhysicianTaxonomy code 2086S0122X
License
041394 Issued in GA
Practice address
111 Marble Mill Rd NW
Marietta, GA 30060-1047
Phone
(770) 422-1013
Fax
(770) 514-5996
NPI assigned
Apr 22, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 26, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X 041394 GA
Plastic and Reconstructive Surgery Physician 2086S0122X 041394 GA Primary

Addresses

Primary practice location

111 Marble Mill Rd NW
Marietta, GA 30060-1047

Mailing address

111 Marble Mill Rd NW
Marietta, GA 30060-1047
Phone (770) 422-1013

Other names 1

  • Seth Adam Yellin Other name

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
I20070503000502 GA Practitioner - Plastic and Reconstructive Surgery 3577669712 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Marietta Dermatology Associates PA CurrentSince Mar 1, 2011 Accepting new patients

Locations

130 Oakside Ct
Ste A
Canton, GA 30114
Phone (770) 422-1013

111 Marble Mill Rd NW
Marietta, GA 30060
Phone (770) 422-1013

840 Church St NE
Ste A1
Marietta, GA 30060
Phone (770) 428-5988

5041 Dallas Hwy
Ste 209
Powder Springs, GA 30127

Organizations & group practices 1

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": "1145664000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1296000000000",
    "number": "1619933249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 MARBLE MILL RD NW",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300601047",
            "telephone_number": "770-422-1013",
            "fax_number": "770-514-5996"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 MARBLE MILL RD NW",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300601047",
            "telephone_number": "770-422-1013",
            "fax_number": "770-514-5996"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YELLIN",
        "first_name": "SETH",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-22",
        "last_updated": "2011-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "GA",
            "license": "041394",
            "primary": false
        },
        {
            "code": "2086S0122X",
            "taxonomy_group": "",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "GA",
            "license": "041394",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SETH",
            "last_name": "YELLIN",
            "middle_name": "ADAM",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Marietta, GA

Sources for this page

Verify at the official NPI Registry.