Active NPI
Mark E Kopel, PA
- Anesthesiologist Assistant
- Atlanta, GA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiologist Assistant
- License
- 000479
- Practice address
- 303 Parkway Dr NE
PMB 404
Atlanta, GA 30312-1212 - Phone
- (404) 265-4520
- Fax
- (404) 265-3894
- NPI assigned
- May 31, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiologist Assistant | 367H00000X | 000479 | GA | Primary |
Addresses
Primary practice location
303 Parkway Dr NE
PMB 404
Atlanta, GA 30312-1212
Mailing address
PO Box 932925
Atlanta, GA 31193-2925
Phone (800) 364-9216
Other identifiers 6
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100002072E | Medicaid | GA | |
| 1770520876 | Other | GA | NPI |
| 100002072F | Medicaid | GA | |
| P00194468 | Other | GA | RR MEDICARE |
| 1982637419 | Other | GA | GROUP NPI |
| N360028 | Other | GA | WELLCARE MEDICAID |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in GA
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Anesthesiology Assistant
- Education
- Other, 1979
- Medicare assignment
- May accept Medicare assignment
- Group practices
Practice addresses (Care Compare)
3000 Hospital Blvd
Roswell, GA 30076-4915
Phone (770) 751-2500
3950 Austell Rd
Austell, GA 30106-1121
Phone (770) 702-1806
Hospital & facility affiliations
- Wellstar North Fulton Medical Center
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Associate of Arts, Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 000479 | GA | MD | Clinical Social Worker |
| 479 | GA | MD | Foot & Ankle Surgery Podiatrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Northlake Anesthesia Professionals, LLC | Current | Accepting new patients | |
| Mak Anesthesia Holdings LLC | Current | Accepting new patients |
Locations
303 Parkway Dr NE
Atlanta, GA 30312
Phone (404) 265-4000
3950 Austell Rd
Austell, GA 30106
Phone (770) 732-3752
601 S 8th St
Griffin, GA 30224
Phone (770) 228-2721
3000 Hospital Blvd
Roswell, GA 30076
Phone (770) 751-2500
4500 Hospital Blvd
Ste 210
Roswell, GA 30076
1491 Montreal Rd
Tucker, GA 30084
Phone (770) 270-1284
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.
-
- Anesthesiology Physician
- Kennesaw, GA
- NPI 1912452939
-
- Anesthesiology Physician
- Atlanta, GA
- NPI 1982637419
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Roswell, GA
- NPI 1750312997
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149033600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1222214400000",
"number": "1770520876",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 932925",
"city": "ATLANTA",
"state": "GA",
"postal_code": "311932925",
"telephone_number": "800-364-9216",
"fax_number": "423-892-5838"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "303 PARKWAY DR NE",
"address_2": "PMB 404",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303121212",
"telephone_number": "404-265-4520",
"fax_number": "404-265-3894"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KOPEL",
"first_name": "MARK",
"middle_name": "E",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-31",
"last_updated": "2008-09-24",
"status": "A"
},
"taxonomies": [
{
"code": "367H00000X",
"taxonomy_group": "",
"desc": "Anesthesiologist Assistant",
"state": "GA",
"license": "000479",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100002072E",
"state": "GA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NPI",
"identifier": "1770520876",
"state": "GA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100002072F",
"state": "GA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR MEDICARE",
"identifier": "P00194468",
"state": "GA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GROUP NPI",
"identifier": "1982637419",
"state": "GA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WELLCARE MEDICAID",
"identifier": "N360028",
"state": "GA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Atlanta, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2008; 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.