PA-C Surgical Assist, LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

PA-C SURGICAL ASSIST, LLC

Practice address

260 Trotters Run
Macon, GA 31210-8653

Phone

(858) 337-0498

Fax

(478) 750-7756

NPI assigned

Jul 2, 2020

Organization subpart

No

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

Authorized official

Name

Tiffany Gibbert, PANPI 1407081581

Title

Owner

Phone

(858) 337-0498

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Tiffany Ann Gibbert, PA-C

  • Physician Assistant
  • Macon, GA
  • NPI 1407081581
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1593648000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1787011200000",
    "number": "1801413174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 26096",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312216096",
            "telephone_number": "858-337-0498",
            "fax_number": "478-750-7756"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "260 TROTTERS RUN",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312108653",
            "telephone_number": "858-337-0498",
            "fax_number": "478-750-7756"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PA-C SURGICAL ASSIST, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-07-02",
        "last_updated": "2026-08-18",
        "certification_date": "2026-08-18",
        "status": "A",
        "authorized_official_last_name": "GIBBERT",
        "authorized_official_first_name": "TIFFANY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "858-337-0498",
        "authorized_official_credential": "PA"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Markisha Owens, NP
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• Ambulatory Surgical Clinic/Center in Macon, GA
• Providers in Macon, GA by specialty
• Ambulatory Surgical Clinic/Center in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.