Bridget M Sroka, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

004991 Issued in GA

Practice address

835 Cogburn Ave NW
Suite 100
Marietta, GA 30060-1031

Phone

(770) 422-5557

Fax

(770) 422-5456

NPI assigned

Dec 20, 2007

Last updated

Oct 10, 2014By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Physician Assistant

Practice roles

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.

• Aqua Dermatology of Georgia PC

  dba Goodman Dermatology, Skin Cancer Specialists PC & Aesthetics Center

  • Dermatology Physician
  • Marietta, GA
  • NPI 1114022167
  NPD (past)

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

{
    "created_epoch": "1198108800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1412899200000",
    "number": "1700060159",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "835 COGBURN AVE NW",
            "address_2": "SUITE 100",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300601031",
            "telephone_number": "770-422-5557",
            "fax_number": "770-422-5456"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "835 COGBURN AVE NW",
            "address_2": "SUITE 100",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300601031",
            "telephone_number": "770-422-5557",
            "fax_number": "770-422-5456"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SROKA",
        "first_name": "BRIDGET",
        "middle_name": "M",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-12-20",
        "last_updated": "2014-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "GA",
            "license": "004991",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Medical Physician Assistant in Marietta, GA
• Providers in Marietta, GA by specialty
• Medical Physician Assistant in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.