Individual provider Active NPI

Maryn Hayward Deyoung, PA-C, MPH

  • Physician Assistant
  • Decatur, GA
National Provider Identifier
1801520564
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
11451 Issued in GA
Practice address
200 E Ponce de Leon Ave Ste 110
Decatur, GA 30030-3467
Phone
(404) 501-6363
NPI assigned
Jul 10, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 13, 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 11451 GA Primary

Addresses

Primary practice location

200 E Ponce de Leon Ave Ste 110
Decatur, GA 30030-3467

Mailing address

200 E Ponce de Leon Ave Ste 110
Decatur, GA 30030-3467
Phone (404) 501-6363

Other names 1

  • Maryn Burns Hayward Former name

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
I20230330000351 GA Practitioner - Physician Assistant 7012381270 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of Alabama School of Medicine, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Emory Clinic IncGroup PAC ID 8820901408, 3,507 clinicians

Practice addresses (Care Compare)

1365 Clifton Rd NE
Atlanta, GA 30322-1013
Phone (404) 778-7525

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Medcura Health, Inc. CurrentSince Mar 2, 2023 Accepting new patients
Medcura Health, Inc. CurrentSince Mar 2, 2023 Accepting new patients
Medcura Health, Inc. Past Accepting new patients
Medcura Health, Inc. Past Accepting new patients
Dekalb Medical Primary Care Group LLC Past Accepting new patients

Locations

5582 Memorial Dr
Stone Mountain, GA 30083
Phone (404) 513-9965

770 Village Square Dr
Stone Mtn, GA 30083
Phone (404) 298-7658

Interoperability endpoints

  • Direct secure messaging: maryn.hayward.1@9679.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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1657411200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1801520564",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 E PONCE DE LEON AVE STE 110",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300303467",
            "telephone_number": "404-501-6363"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 E PONCE DE LEON AVE STE 110",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300303467",
            "telephone_number": "404-501-6363"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEYOUNG",
        "first_name": "MARYN",
        "middle_name": "HAYWARD",
        "credential": "PA-C, MPH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-07-10",
        "last_updated": "2026-07-13",
        "certification_date": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "11451",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARYN",
            "last_name": "HAYWARD",
            "middle_name": "BURNS",
            "credential": "PA-C, MPH",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Decatur, GA

Sources for this page

Verify at the official NPI Registry.