Leslie Rosenblatt-Brown, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

3987 Issued in GA

Practice address

1275 Highway 54 W
Suite 201
Fayetteville, GA 30214-4549

Phone

(770) 461-3776

Fax

(770) 461-3565

NPI assigned

Aug 30, 2006

Last updated

Sep 1, 2010By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

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.

• Privia Medical Group of Georgia LLC

  • Internal Medicine Physician
  • Fayetteville, GA
  • NPI 1013313857
  Medicare reassignment
• Undeniable Healthcare

  • Family Medicine Physician
  • Peachtree City, GA
  • NPI 1871062489
  Medicare reassignment
• Privia Medical Group of Georgia LLC

  • Internal Medicine Physician
  • Savannah, GA
  • NPI 1356907273
  NPD
• Atlanta Primary Care Peachtree, PC

  • Specialist
  • Newnan, GA
  • NPI 1477573293
  NPD (past)
• Aylo Health, LLC

  • Family Medicine Physician
  • Atlanta, GA
  • NPI 1013018811
  NPD (past)
• Aylo Health, LLC

  • Family Medicine Physician
  • Locust Grove, GA
  • NPI 1710929914
  NPD (past)
• Aylo Health, LLC

  • Sleep Medicine (Family Medicine) Physician
  • Stockbridge, GA
  • NPI 1922831445
  NPD (past)
• Jeffrey a. Sherman, MD, PC

  dba Your Family Doctor

  • Family Medicine Physician
  • Peachtree City, GA
  • NPI 1447476593
  NPD (past)

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1283299200000",
    "number": "1801906474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1275 HIGHWAY 54 W",
            "address_2": "SUITE 201",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302144549",
            "telephone_number": "770-461-3776",
            "fax_number": "770-461-3565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1275 HIGHWAY 54 W",
            "address_2": "SUITE 201",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302144549",
            "telephone_number": "770-461-3776",
            "fax_number": "770-461-3565"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSENBLATT-BROWN",
        "first_name": "LESLIE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-30",
        "last_updated": "2010-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "3987",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLCARE",
            "identifier": "319981",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "451479533A",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIGROUP",
            "identifier": "10033138",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kim Martinet Rolle, PHARM.D.
• Mikayla Rolle, MSOT
• Emma Romigh, PA
• Rose's Hands
• Charity Nikole Roseberry, PMHNP-BC
• Jacqueline Denise Ross, CRNP
• Jose Rossello, MD
• Lacrecia Rosser, OTR/L
• Decheyla Rouse
• Spencer O. Rowland, PA

• Physician Assistant in Fayetteville, GA
• Providers in Fayetteville, GA by specialty
• Physician Assistant in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.