Individual provider Active NPI

Megan Deanne Tracy

  • Physician Assistant
  • Roswell, GA
National Provider Identifier
1790273597
Registry record updated Aug 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
1357 Hembree Rd Ste 250
Roswell, GA 30076-5724
Phone
(770) 754-0787
Fax
(770) 755-5890
NPI assigned
Apr 26, 2018
Last updated
Aug 12, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X NU Primary

Addresses

Primary practice location

1357 Hembree Rd Ste 250
Roswell, GA 30076-5724

Mailing address

1357 Hembree Rd Ste 250
Roswell, GA 30076-5724
Phone (770) 754-0787

Other practice location 1

460 Northside Cherokee Blvd Ste 410
Canton, GA 30115-8023
Phone (470) 242-0730

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
I20180830001540 GA Practitioner - Physician Assistant 8325398068 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aqua Dermatology of Georgia PCGroup PAC ID 6800885757, 56 clinicians

Practice addresses (Care Compare)

460 Northside Cherokee Blvd
Suite 410
Canton, GA 30115-8023
Phone (470) 242-0730

835 Cogburn Ave NW
Suite 100
Marietta, GA 30060-1008
Phone (770) 422-5557

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Aqua Dermatology of Georgia PC CurrentSince Jun 1, 2024 Accepting new patients
Aqua Dermatology of Florida, PA PastSince May 1, 2022 Accepting new patients
Water's Edge Dermatology, LLC Past Accepting new patients

Locations

1255 Friendship Rd
Ste 120
Braselton, GA 30517
Phone (470) 201-7777

1839 Buford Hwy
Ste 100
Buford, GA 30518
Phone (470) 242-0715

470 Northside Cherokee Blvd
Ste 170
Canton, GA 30115
Phone (404) 250-6691

2870 Ronald Reagan Blvd
Ste 103
Cumming, GA 30041
Phone (248) 601-4900

5983 Highway 53 E
Ste 200
Dawsonville, GA 30534
Phone (770) 754-0787

1163 Johnson Ferry Rd
Ste 250
Marietta, GA 30068
Phone (770) 321-1001

835 Cogburn Ave NW
Ste 100
Marietta, GA 30060
Phone (770) 422-5557

1357 Hembree Rd
Ste 250
Roswell, GA 30076
Phone (770) 475-7550

4298 Atlanta Rd SE
Ste 320
Smyrna, GA 30080
Phone (470) 242-0717

2001 Professional Way
Ste 250
Woodstock, GA 30188
Phone (770) 754-0787

Interoperability endpoints

  • Direct secure messaging: mtracy@directaddress.net

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1524700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786492800000",
    "number": "1790273597",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1357 HEMBREE RD STE 250",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "300765724",
            "telephone_number": "770-754-0787",
            "fax_number": "770-755-5890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1357 HEMBREE RD STE 250",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "300765724",
            "telephone_number": "770-754-0787",
            "fax_number": "770-755-5890"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "460 Northside Cherokee Blvd Ste 410",
            "address_purpose": "LOCATION",
            "city": "Canton",
            "state": "GA",
            "postal_code": "301158023",
            "country_code": "US",
            "telephone_number": "470-242-0730",
            "fax_number": "770-755-5890",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TRACY",
        "first_name": "MEGAN",
        "middle_name": "DEANNE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-26",
        "last_updated": "2026-08-12",
        "certification_date": "2026-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roswell, GA

Sources for this page

Verify at the official NPI Registry.