Individual provider Active NPI

Tyler Jaffe, PA-C

  • Physician Assistant
  • Atlanta, GA
National Provider Identifier
1649914284
Registry record updated Apr 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
10983 Issued in GA
Practice address
3240 Northeast Expy NE
Atlanta, GA 30341-4003
Phone
(404) 480-9330
NPI assigned
Apr 20, 2022
Last updated
Apr 20, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2022

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 10983 GA Primary

Addresses

Primary practice location

3240 Northeast Expy NE
Atlanta, GA 30341-4003

Mailing address

3436 Oak Canyon Cir
Mountain BRK, AL 35243-4808
Phone (205) 908-5407

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
I20230616001536 GA Practitioner - Physician Assistant 7315305737 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Peachtree Orthopaedic Clinic PAGroup PAC ID 4587552963, 138 clinicians

Practice addresses (Care Compare)

1901 Phoenix Blvd
Suite 200
College Park, GA 30349-5062
Phone (404) 355-6548

2001 Peachtree Rd NE
Suite 705
Atlanta, GA 30309-1476
Phone (404) 355-0743

3200 Downwood Cir NW
Suite 700
Atlanta, GA 30327-5308
Phone (404) 355-0743

5505 Peachtree Dunwoody Rd
Suite 600
Atlanta, GA 30342-1717
Phone (404) 425-1577

Merit-based Incentive Payment System (MIPS)

Final score
94.9 of 100Reported as group
Promoting interoperability
94
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Peachtree Orthopaedic Clinic P.a. CurrentSince Mar 27, 2023 Accepting new patients
Peachtree Orthopaedic Clinic CurrentSince Mar 27, 2023 Accepting new patients
Barbour Orthopaedics & Sports Medicine PC Past Accepting new patients
Peachtree Orthopaedic Clinic PA Past Accepting new patients

Locations

2001 Peachtree Rd NE
Ste 705
Atlanta, GA 30309

3200 Downwood Cir NW
Ste 500
Atlanta, GA 30327
Phone (404) 352-4500

1901 Phoenix Blvd
Ste 200
College Park, GA 30349
Phone (404) 355-6548

Interoperability endpoints

  • Direct secure messaging: tyler.jaffe.1@8474.direct.athenahealth.com

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": "1650412800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650412800000",
    "number": "1649914284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3436 OAK CANYON CIR",
            "city": "MOUNTAIN BRK",
            "state": "AL",
            "postal_code": "352434808",
            "telephone_number": "205-908-5407"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3240 NORTHEAST EXPY NE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303414003",
            "telephone_number": "404-480-9330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAFFE",
        "first_name": "TYLER",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-04-20",
        "last_updated": "2022-04-20",
        "certification_date": "2022-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "10983",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.