Individual provider Active NPI

Patrice Rebecca Braun, PHYSICIAN ASSISTANT

  • Surgical Physician Assistant
  • Atlanta, GA
National Provider Identifier
1740356161
Registry record updated Feb 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
004918 Issued in GA
Practice address
2001 Peachtree Rd NE Ste 575
Atlanta, GA 30309-1476
Phone
(404) 350-0106
Fax
(404) 350-0176
NPI assigned
Nov 28, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 004918 GA
Surgical Physician Assistant 363AS0400X 004918 GA Primary

Addresses

Primary practice location

2001 Peachtree Rd NE Ste 575
Atlanta, GA 30309-1476

Mailing address

2001 Peachtree Rd NE Ste 575
Atlanta, GA 30309-1476
Phone (404) 350-0106

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address patrice.braun.1@11968.direct.athenahealth.com Direct

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
I20070212000069 GA Practitioner - Physician Assistant 7618979295 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Northside Surgical Professional Services LLCGroup PAC ID 8628253424, 367 clinicians

Practice addresses (Care Compare)

1000 Johnson Ferry NE
Atlanta, GA 30342-1606

1000 Johnson Ferry Rd NE
Atlanta, GA 30342-1606
Phone (404) 851-8000

980 Johnson Ferry Rd
Atlanta, GA 30342-1607

Hospital & facility affiliations

  • Northside Hospital Hospital, Atlanta, GA, CCN 110161
  • Northside Hospital Cherokee Hospital, Canton, GA, CCN 110008

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
004918GAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Piedmont Providers LLC PastSince Mar 27, 2006 Accepting new patients

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1164672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614297600000",
    "number": "1740356161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2001 PEACHTREE RD NE STE 575",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303091476",
            "telephone_number": "404-350-0106",
            "fax_number": "404-350-0176"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 PEACHTREE RD NE STE 575",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303091476",
            "telephone_number": "404-350-0106",
            "fax_number": "404-350-0176"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRAUN",
        "first_name": "PATRICE",
        "middle_name": "REBECCA",
        "name_prefix": "Ms.",
        "credential": "PHYSICIAN ASSISTANT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-28",
        "last_updated": "2021-02-26",
        "certification_date": "2021-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "004918",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "GA",
            "license": "004918",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "patrice.braun.1@11968.direct.athenahealth.com",
            "affiliation": "N",
            "endpointDescription": "Direct Messaging",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Direct Edge",
            "address_1": "2001 Peachtree Rd NE Ste 575",
            "city": "Atlanta",
            "state": "GA",
            "country_code": "US",
            "postal_code": "303091476",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.