Seth Monroe Park, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

9020 Issued in GA

Practice address

4155 Baker St NE Ste 100
Covington, GA 30014-1405

Phone

(770) 788-0620

NPI assigned

Dec 10, 2018

Last updated

Mar 31, 2020By the provider in NPPES

Sex

Male

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

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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.

• The Derm Center of Newton

  • Dermatology Physician
  • Covington, GA
  • NPI 1679682561
  Medicare reassignment

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

{
    "created_epoch": "1544400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585612800000",
    "number": "1730650144",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4155 BAKER ST NE STE 100",
            "city": "COVINGTON",
            "state": "GA",
            "postal_code": "300141405",
            "telephone_number": "770-788-0620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4155 BAKER ST NE STE 100",
            "city": "COVINGTON",
            "state": "GA",
            "postal_code": "300141405",
            "telephone_number": "770-788-0620"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "SETH MONROE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-12-10",
        "last_updated": "2020-03-31",
        "certification_date": "2020-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "9020",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brianna O Ozenne
• Karissa Pace
• Wesley Pace
• Judy Marlena Page, NP
• Paralife EMS
• Ashley Difolco Parker, PTA
• Ashna Parti, DO
• Madison Partlow
• Partnership Community Health, Inc.
• Kierra Paschal

• Physician Assistant in Covington, GA
• Providers in Covington, GA by specialty
• Physician Assistant in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.