Individual provider Active NPI

Abigail Huerta, PA

  • Physician Assistant
  • Lawrenceville, GA
National Provider Identifier
1780225664
Registry record updated Jan 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
00000 Issued in GA
Practice address
301 Philip Blvd Ste a
Lawrenceville, GA 30046-8746
Phone
(770) 822-5560
Fax
(770) 822-4989
NPI assigned
Oct 2, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Physician Assistant 363A00000X 00000 GA Primary

Addresses

Primary practice location

301 Philip Blvd Ste a
Lawrenceville, GA 30046-8746

Mailing address

301 Philip Blvd Ste a
Lawrenceville, GA 30046-8746
Phone (770) 822-5560

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
I20210428001061 GA Practitioner - Physician Assistant 7719395979 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Emory University School of Medicine, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aga Professional Services LLCGroup PAC ID 3870768997, 175 clinicians

Practice addresses (Care Compare)

488 Kennesaw Ave NW
Suite 200
Marietta, GA 30060-9409
Phone (770) 427-3075

Hospital & facility affiliations

  • Northside Hospital Gwinnett Hospital, Lawrenceville, GA, CCN 110087
  • Northside Hospital Duluth Hospital, Duluth, GA, CCN 110252
  • Piedmont Eastside Medical Center Hospital, Snellville, GA, CCN 110192

Merit-based Incentive Payment System (MIPS)

Final score
74.39 of 100Reported as group
Quality
44.91
Promoting interoperability
98
Improvement activities
40
Cost
71.38

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
00000GAMDOptometrist

Interoperability endpoints

  • Direct secure messaging: abigail.huerta@ud.eclinicaldirectplus.com

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 3

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": "1569974400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610236800000",
    "number": "1780225664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 PHILIP BLVD STE A",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300468746",
            "telephone_number": "770-822-5560",
            "fax_number": "770-822-4989"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 PHILIP BLVD STE A",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300468746",
            "telephone_number": "770-822-5560",
            "fax_number": "770-822-4989"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUERTA",
        "first_name": "ABIGAIL",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-02",
        "last_updated": "2021-01-10",
        "certification_date": "2021-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "00000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lawrenceville, GA

Sources for this page

Verify at the official NPI Registry.