Individual provider Active NPI

Adam Dalzell, PA-C

  • Physician Assistant
  • Atlanta, GA
National Provider Identifier
1659867711
Registry record updated Apr 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
11005 Issued in GA
Practice address
882 Ponce de Leon Ave NE
Atlanta, GA 30306-4268
Phone
(708) 093-0347
NPI assigned
Jul 2, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 022090 NY
Physician Assistant 363A00000X 11005 GA Primary

Addresses

Primary practice location

882 Ponce de Leon Ave NE
Atlanta, GA 30306-4268

Mailing address

1026 Calibre Springs Way
Atlanta, GA 30342-1879
Phone (305) 527-8841

Other practice location 1

1026 Calibre Springs Way
Atlanta, GA 30342-1879
Phone (305) 527-8841

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
I20230419001228 GA Practitioner - Physician Assistant 1658624374 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wellstreet of Georgia PCGroup PAC ID 7517126279, 425 clinicians

Practice addresses (Care Compare)

10945 State Bridge Rd
Suite 501
Alpharetta, GA 30022-8163
Phone (404) 996-0194

2292 Peachtree Rd
Atlanta, GA 30309-1147
Phone (404) 382-9941

2637 Peachtree Pkwy
Suwanee, GA 30024-1048
Phone (678) 660-5137

2701 Holcomb Bridge Rd
Alpharetta, GA 30022-6812
Phone (770) 998-7611

6660 Roswell Nerd
Sandy Springs, GA 30328-3167
Phone (404) 996-0195

Merit-based Incentive Payment System (MIPS)

Final score
91.62 of 100Reported as apm
Quality
83.25
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11005GAMDGeneral Practice Dentistry

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": "1530489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682035200000",
    "number": "1659867711",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1026 CALIBRE SPRINGS WAY",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303421879",
            "telephone_number": "305-527-8841"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "882 PONCE DE LEON AVE NE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303064268",
            "telephone_number": "708-093-0347"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1026 Calibre Springs Way",
            "address_purpose": "LOCATION",
            "city": "Atlanta",
            "state": "GA",
            "postal_code": "303421879",
            "country_code": "US",
            "telephone_number": "305-527-8841",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DALZELL",
        "first_name": "ADAM",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-07-02",
        "last_updated": "2023-04-21",
        "certification_date": "2023-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "022090",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "11005",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.