Individual provider Active NPI

Sharon Staruch-Christopher, PA

  • Medical Physician Assistant
  • Lawrenceville, GA
National Provider Identifier
1720332851
Registry record updated Jun 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA14124 Issued in CA
Practice address
771 Old Norcross Rd
Lawrenceville, GA 30046-4386
Phone
(949) 276-4141
NPI assigned
Oct 26, 2012
Last updated
Jun 4, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA14124 CA Primary
Dermatology Physician 207N00000X 10667 GA

Addresses

Primary practice location

771 Old Norcross Rd
Lawrenceville, GA 30046-4386

Mailing address

771 Old Norcross Rd Ste 260
Lawrenceville, GA 30046-4981
Phone (770) 962-5040

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
I20220311000937 GA Practitioner - Physician Assistant 9537554464 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Advanced Dermatology of Georgia, LLCGroup PAC ID 9638485782, 15 clinicians

Practice addresses (Care Compare)

771 Old Norcross Rd
Suite 260
Lawrenceville, GA 30046-4981
Phone (770) 962-5040

Merit-based Incentive Payment System (MIPS)

Final score
94.02 of 100Reported as group
Quality
88.03
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA14124CAMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
North Georgia Dermatology, P.C. Dermatology CurrentSince Jun 11, 2023 Accepting new patients
Richard a. Gangnes M.D. Inc. PastSince Nov 27, 2010 Accepting new patients
Pacificoast Ambulatory Surgicenter, LLC. Past Accepting new patients

Locations

2089 Teron Trce
Ste 200
Dacula, GA 30019
Phone (770) 848-5300

771 Old Norcross Rd
Ste 260
Lawrenceville, GA 30046
Phone (770) 962-5040

Interoperability endpoints

  • Direct secure messaging: schristopher@dca.emadirect.md

Organizations & group practices 5

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": "1351209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685836800000",
    "number": "1720332851",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "771 OLD NORCROSS RD STE 260",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300464981",
            "telephone_number": "770-962-5040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "771 OLD NORCROSS RD",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300464386",
            "telephone_number": "949-276-4141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STARUCH-CHRISTOPHER",
        "first_name": "SHARON",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-10-26",
        "last_updated": "2023-06-04",
        "certification_date": "2023-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "PA14124",
            "primary": true
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "GA",
            "license": "10667",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lawrenceville, GA

Sources for this page

Verify at the official NPI Registry.