Individual provider Active NPI

Jason Alexander Brustein, D.O.

  • Orthopaedic Surgery Physician
  • McDonough, GA
National Provider Identifier
1629484340
Registry record updated Aug 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
85137 Issued in GA
Practice address
105 Regency Park Dr
McDonough, GA 30253-6649
Phone
(770) 506-4119
Fax
(770) 506-4145
NPI assigned
Jul 2, 2014
Last updated
Aug 3, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 3, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 85137 GA Primary
Orthopaedic Surgery Physician 207X00000X OT015677 PA

Addresses

Primary practice location

105 Regency Park Dr
McDonough, GA 30253-6649

Mailing address

105 Regency Park Dr
McDonough, GA 30253-6649
Phone (770) 506-4119

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
I20200518000596 GA Practitioner - Orthopedic Surgery 4587882790 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
New York College of Osteo Medicine of New York Institute of Technology, 2014
Medicare assignment
May accept Medicare assignment
Group practices
Resurgens, LLCGroup PAC ID 1153224142, 184 clinicians
Matrix Rehabilitation-Georgia IncGroup PAC ID 2567379498, shared by 4 NPIs, 40 clinicians

Practice addresses (Care Compare)

1336 Hwy 54 W
BLDG 400 Suite C
Fayetteville, GA 30214-4574
Phone (770) 461-6142

1585 N Expressway
Griffin, GA 30223-1746
Phone (770) 227-7050

2041 Mesa Valley Way
Suite 100
Austell, GA 30106-6856

234 Jonesboro Rd
McDonough, GA 30253-3720
Phone (770) 954-9631

2712 N Decatur Rd
Decatur, GA 30033-5910
Phone (770) 491-3003

3885 Princeton Lakes Way SW
Suite 310
Atlanta, GA 30331-7100
Phone (470) 773-6710

5671 Peachtree Dunwoody Rd
Suite 900
Atlanta, GA 30342-5022

5671 Peachtree Dunwoody Rd NE
Suite 900 950
Atlanta, GA 30342-5022
Phone (404) 847-9999

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.93 of 100Reported as apm
Quality
82.14
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hip replacement1-10
Knee replacement15
Lower limb (leg) arthroscopy (minimally invasive joint repair)1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
85137GAMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Resurgens, LLC Orthopaedic Surgery CurrentSince May 1, 2020 Accepting new patients
Resurgens, LLC Orthopaedic Surgery CurrentSince May 1, 2020 Accepting new patients

Locations

3885 Princeton Lakes Way SW
Ste 310
Atlanta, GA 30331
Phone (404) 346-9233

1336 Highway 54 W
Bldg 400
Fayetteville, GA 30214
Phone (770) 461-1238

1336 Highway 54 W
Bldg 500
Fayetteville, GA 30214
Phone (770) 461-1238

1585 N Expressway
Griffin, GA 30223
Phone (770) 227-7050

105 Regency Park Dr
McDonough, GA 30253
Phone (770) 506-4119

156 Foster Dr
Ste B
McDonough, GA 30253
Phone (770) 506-4119

2301 Newnan Crossing Blvd E
Ste 100
Newnan, GA 30265
Phone (678) 333-6600

5671 Ptree Dunwoody Rd NE
Ste 700
Sandy Springs, GA 30342
Phone (404) 459-3732

5671 Ptree Dunwoody Rd NE
Ste 900
Sandy Springs, GA 30342
Phone (404) 531-8590

Interoperability endpoints

  • Direct secure messaging: jason.brustein.1@15749.direct.athenahealth.com
  • Direct secure messaging: jason.brustein.1@19873.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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1404259200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596412800000",
    "number": "1629484340",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 REGENCY PARK DR",
            "city": "MCDONOUGH",
            "state": "GA",
            "postal_code": "302536649",
            "telephone_number": "770-506-4119",
            "fax_number": "770-506-4145"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 REGENCY PARK DR",
            "city": "MCDONOUGH",
            "state": "GA",
            "postal_code": "302536649",
            "telephone_number": "770-506-4119",
            "fax_number": "770-506-4145"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUSTEIN",
        "first_name": "JASON",
        "middle_name": "ALEXANDER",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-07-02",
        "last_updated": "2020-08-03",
        "certification_date": "2020-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "GA",
            "license": "85137",
            "primary": true
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "PA",
            "license": "OT015677",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in McDonough, GA

Sources for this page

Verify at the official NPI Registry.