Individual provider Active NPI

Tabitha Maya Transue, PA-C

  • Physician Assistant
  • Roswell, GA
National Provider Identifier
1689398232
Registry record updated Mar 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
2500 Hospital Blvd Ste 280
Roswell, GA 30076-4918
Phone
(770) 754-0787
Fax
(770) 755-5890
NPI assigned
Sep 28, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 13, 2024

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 Primary

Addresses

Primary practice location

2500 Hospital Blvd Ste 280
Roswell, GA 30076-4918

Mailing address

2500 Hospital Blvd Ste 280
Roswell, GA 30076-4918
Phone (770) 754-0787

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
I20240617000487 GA Practitioner - Physician Assistant 6406399690 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aqua Dermatology of Georgia PCGroup PAC ID 6800885757, 56 clinicians

Practice addresses (Care Compare)

7316 Spout Springs Rd
Suite 203
Flowery Branch, GA 30542-5620
Phone (470) 242-0714

835 Cogburn Ave NW
Suite 100
Marietta, GA 30060-1008
Phone (770) 422-5557

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Dermatopathology Lab of Skin Cancer Specialists, P.C. CurrentSince Jun 1, 2024 Accepting new patients

Locations

1255 Friendship Rd
Ste 120
Braselton, GA 30517
Phone (470) 201-7777

1839 Buford Hwy
Ste 100
Buford, GA 30518
Phone (678) 450-9933

470 Northside Cherokee Blvd
Ste 170
Canton, GA 30115
Phone (770) 721-9540

2870 Ronald Reagan Blvd
Ste 103
Cumming, GA 30041
Phone (248) 601-4900

5983 Highway 53 E
Ste 200
Dawsonville, GA 30534
Phone (770) 754-0787

1163 Johnson Ferry Rd
Ste 250
Marietta, GA 30068
Phone (770) 321-1001

835 Cogburn Ave NW
Ste 100
Marietta, GA 30060
Phone (770) 422-5557

1357 Hembree Rd
Ste 250
Roswell, GA 30076
Phone (770) 475-7550

4298 Atlanta Rd SE
Ste 320
Smyrna, GA 30080
Phone (470) 242-0717

2001 Professional Way
Ste 250
Woodstock, GA 30188
Phone (770) 754-0787

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 and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1664323200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710288000000",
    "number": "1689398232",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 HOSPITAL BLVD STE 280",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "300764918",
            "telephone_number": "770-754-0787",
            "fax_number": "770-755-5890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 HOSPITAL BLVD STE 280",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "300764918",
            "telephone_number": "770-754-0787",
            "fax_number": "770-755-5890"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRANSUE",
        "first_name": "TABITHA",
        "middle_name": "MAYA",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-09-28",
        "last_updated": "2024-03-13",
        "certification_date": "2024-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roswell, GA

Sources for this page

Verify at the official NPI Registry.