Individual provider Active NPI

Maelynn La, MD

  • Cardiovascular Disease Physician
  • Tucker, GA
National Provider Identifier
1669931812
Registry record updated May 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
104179 Issued in GA
Practice address
1468 Montreal Rd
Tucker, GA 30084-6901
Phone
(770) 638-1400
Fax
(770) 638-1411
NPI assigned
Mar 18, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 13, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X TRN34942 FL
Cardiovascular Disease Physician 207RC0000X 104179 GA Primary
Student in an Organized Health Care Education/Training Program 390200000X 34942 FL

Addresses

Primary practice location

1468 Montreal Rd
Tucker, GA 30084-6901

Mailing address

655 W 8TH St FL Center
Cardiovascular Center Box C-35
Jacksonville, FL 32209-6511
Phone (904) 244-3932

Other practice location 1

UF Health Jacksonville
655 West 8th Street
Jacksonville, FL 32209
Phone (904) 244-3932

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
I20260611004216 GA Practitioner - Cardiovascular Disease (Cardiology) 7315318615 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
Tulane University School of Medicine, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Atlanta Heart Specialists LLCGroup PAC ID 9537134341, 21 clinicians

Practice addresses (Care Compare)

1468 Montreal Rd
Tucker, GA 30084-6901
Phone (770) 638-1400

Hospital & facility affiliations

  • Emory Decatur Hospital Hospital, Decatur, GA, CCN 110076
  • Emory Hillandale Hospital Hospital, Lithonia, GA, CCN 110226
  • Saint Joseph'S Hospital of Atlanta, Inc Hospital, Atlanta, GA, CCN 110082

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
104179GAMDCardiovascular Disease Physician
34942FLMDStudent in an Organized Health Care Education/Training Program
TRN34942FLMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Atlanta Heart Specialists LLC Cardiovascular Disease PastSince Jul 19, 2024 Accepting new patients

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/FIFCAA

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.

Hospital & facility affiliations 3

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": "1552867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747094400000",
    "number": "1669931812",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "655 W 8TH ST FL CENTER",
            "address_2": "CARDIOVASCULAR CENTER BOX C-35",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322096511",
            "telephone_number": "904-244-3932",
            "fax_number": "904-244-3629"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1468 MONTREAL RD",
            "city": "TUCKER",
            "state": "GA",
            "postal_code": "300846901",
            "telephone_number": "770-638-1400",
            "fax_number": "770-638-1411"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "UF Health Jacksonville",
            "address_2": "655 West 8th Street",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "32209",
            "country_code": "US",
            "telephone_number": "904-244-3932",
            "fax_number": "904-244-3629",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LA",
        "first_name": "MAELYNN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-18",
        "last_updated": "2025-05-13",
        "certification_date": "2025-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "FL",
            "license": "TRN34942",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "GA",
            "license": "104179",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "FL",
            "license": "34942",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucker, GA

Sources for this page

Verify at the official NPI Registry.