Individual provider Active NPI

Scott Phillip Siegel, P.A.-C

  • Physician Assistant
  • Atlanta, GA
National Provider Identifier
1790950269
Registry record updated Jul 18, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
008847 Issued in GA
Practice address
5671 Peachtree Dunwoody Rd Ste 900
Atlanta, GA 30342
Phone
(404) 847-9999
Fax
(404) 531-8466
NPI assigned
Apr 25, 2008
Last updated
Jul 18, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2018

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 PA9104370 FL
Physician Assistant 363A00000X 008847 GA Primary

Addresses

Primary practice location

5671 Peachtree Dunwoody Rd Ste 900
Atlanta, GA 30342

Mailing address

5671 Peachtree Dunwoody Rd Ste 900
Atlanta, GA 30342-5022
Phone (404) 847-9999

Other identifiers 2

IdentifierTypeStateIssuer
005482700MedicaidFL
003123833AMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, GA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20101109001368 FL Practitioner - Physician Assistant 4981899531 Reassigns benefits to 2 organizations
I20180821004089 GA Practitioner - Physician Assistant 4981899531 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Resurgens, LLCGroup PAC ID 1153224142, 184 clinicians

Practice addresses (Care Compare)

5671 Peachtree Dunwoody Rd
Suite 900
Atlanta, GA 30342-5022

5671 Peachtree Dunwoody Rd NE
Suite 900 950
Atlanta, GA 30342-5022
Phone (404) 847-9999

758 Old Norcross Rd
Suite 175
Lawrenceville, GA 30046-3386
Phone (678) 985-7190

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Resurgens, LLC CurrentSince Aug 1, 2018 Accepting new patients
University of Florida Jacksonville Physicians Inc CurrentSince May 21, 2012 Accepting new patients
Resurgens, LLC CurrentSince Aug 1, 2018 Accepting new patients
St Vincents Ambulatory Care Inc CurrentSince Jan 4, 2014 Accepting new patients
University of Florida Jacksonville Physicians, Inc. CurrentSince May 21, 2012 Accepting new patients

Locations

3 Shircliff Way
Ste 714
Jacksonville, FL 32204
Phone (904) 305-1350

655 W 8th St
Jacksonville, FL 32209
Phone (904) 244-1680

800 Prudential Dr
Jacksonville, FL 32207
Phone (904) 202-2000

5671 Ptree Dunwoody Rd NE
Ste 700
Sandy Springs, GA 30342
Phone (404) 459-3732

5671 Ptree Dunwoody Rd NE
Ste 900
Sandy Springs, GA 30342
Phone (404) 531-8590

Interoperability endpoints

  • Direct secure messaging: scott.siegel.1@15749.direct.athenahealth.com

Organizations & group practices 6

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.

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": "1209081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1531872000000",
    "number": "1790950269",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5671 PEACHTREE DUNWOODY RD STE 900",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303425022",
            "telephone_number": "404-847-9999",
            "fax_number": "404-531-8466"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5671 PEACHTREE DUNWOODY RD STE 900",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "30342",
            "telephone_number": "404-847-9999",
            "fax_number": "404-531-8466"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIEGEL",
        "first_name": "SCOTT",
        "middle_name": "PHILLIP",
        "name_prefix": "Mr.",
        "credential": "P.A.-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-04-25",
        "last_updated": "2018-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9104370",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "008847",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "005482700",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003123833A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.