NPIMap

Organization Active NPI

Excelsior Healthcare LLC

  • Family Medicine Physician
  • Norcross, GA
National Provider Identifier
1740142843
Registry record updated Apr 17, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
EXCELSIOR HEALTHCARE LLC
Practice address
777 W Peachtree St
Norcross, GA 30071-1868
Phone
(770) 246-6100
Fax
(770) 246-6142
NPI assigned
Nov 26, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2026

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

Authorized official

Name
Selina Zhu
Title
Credentialing Coordinator
Phone
(770) 246-6100

Specialties & licenses 10

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X
Cardiovascular Disease PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RC0000X
Endocrinology, Diabetes & Metabolism PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RE0101X
Gastroenterology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RG0100X
Clinical Pathology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207ZC0006X
Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0800X
Diagnostic Radiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2085R0202X
Pain Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208VP0000X
Primary Care Clinic/Center 261QP2300X

Addresses

Primary practice location

777 W Peachtree St
Norcross, GA 30071-1868

Mailing address

777 W Peachtree St
Norcross, GA 30071-1868

Other practice location 1

277 E Crogan St
Lawrenceville, GA 30046-5054
Phone (770) 822-4411

Other practice location 2

2805 Hamilton Mill Rd
Buford, GA 30519-4110
Phone (678) 541-0588

Other practice location 3

275 Carpenter Dr Ste 100
Atlanta, GA 30328-4909
Phone (404) 497-9739

Other practice location 4

4855 River Green Pkwy Ste 520
Duluth, GA 30096-8337
Phone (678) 417-1588

Other practice location 5

3895 Johns Creek Pkwy Ste B
Suwanee, GA 30024-1295
Phone (770) 203-0618

Other practice location 6

4470 Satellite Blvd Ste 204
Duluth, GA 30096-8851
Phone (770) 858-5983

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20251226001745 GA Part B Supplier - Clinic/Group Practice 0840786000 Receives reassigned benefits from 8 practitioners
Practice locations: Suwanee, GA; Buford, GA; Norcross, GA; Lawrenceville, GA; Duluth, GA; Atlanta, GA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
11D2345974Excelsior Healthcare LLC4470 Satellite Blvd, Ste 204, Duluth, GA 30096Certificate of waiverJun 21, 2028

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1764115200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1776384000000",
    "number": "1740142843",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "777 W PEACHTREE ST",
            "city": "NORCROSS",
            "state": "GA",
            "postal_code": "300711868"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "777 W PEACHTREE ST",
            "city": "NORCROSS",
            "state": "GA",
            "postal_code": "300711868",
            "telephone_number": "770-246-6100",
            "fax_number": "770-246-6142"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "277 E Crogan St",
            "address_purpose": "LOCATION",
            "city": "Lawrenceville",
            "state": "GA",
            "postal_code": "300465054",
            "country_code": "US",
            "telephone_number": "770-822-4411",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2805 Hamilton Mill Rd",
            "address_purpose": "LOCATION",
            "city": "Buford",
            "state": "GA",
            "postal_code": "305194110",
            "country_code": "US",
            "telephone_number": "678-541-0588",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "275 Carpenter Dr Ste 100",
            "address_purpose": "LOCATION",
            "city": "Atlanta",
            "state": "GA",
            "postal_code": "303284909",
            "country_code": "US",
            "telephone_number": "404-497-9739",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4855 River Green Pkwy Ste 520",
            "address_purpose": "LOCATION",
            "city": "Duluth",
            "state": "GA",
            "postal_code": "300968337",
            "country_code": "US",
            "telephone_number": "678-417-1588",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3895 Johns Creek Pkwy Ste B",
            "address_purpose": "LOCATION",
            "city": "Suwanee",
            "state": "GA",
            "postal_code": "300241295",
            "country_code": "US",
            "telephone_number": "770-203-0618",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4470 Satellite Blvd Ste 204",
            "address_purpose": "LOCATION",
            "city": "Duluth",
            "state": "GA",
            "postal_code": "300968851",
            "country_code": "US",
            "telephone_number": "770-858-5983",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "EXCELSIOR HEALTHCARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-11-26",
        "last_updated": "2026-04-17",
        "certification_date": "2026-04-17",
        "status": "A",
        "authorized_official_last_name": "ZHU",
        "authorized_official_first_name": "SELINA",
        "authorized_official_title_or_position": "CREDENTIALING COORDINATOR",
        "authorized_official_telephone_number": "770-246-6100"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207ZC0006X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pathology, Clinical Pathology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208VP0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pain Medicine, Pain Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Norcross, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.