Mikaela M Peribonio, AGNP-C

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

NP291729 Issued in GA

Practice address

790 Church St NE Ste 300
Marietta, GA 30060-8940

Phone

(770) 422-3290

Fax

(770) 422-0287

NPI assigned

Sep 19, 2022

Last updated

Nov 20, 2025By 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 2

Addresses

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

Specialty

Nurse Practitioner

Education

University of Alabama School of Medicine, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Physiotherapy Associates IncGroup PAC ID 3577470442, shared by 50 NPIs, 1,432 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mikaela.peribonio.1@15749.direct.athenahealth.com

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.

• Resurgens, LLC

  dba Resurgens Orthopaedics

  • Orthopaedic Surgery Physician
  • Braselton, GA
  • NPI 1033919790
  NPD
• Resurgens, LLC

  dba Resurgens Orthopaedics

  • Orthopaedic Surgery Physician
  • Atlanta, GA
  • NPI 1386697928
  NPD

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

{
    "created_epoch": "1663545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763596800000",
    "number": "1811610553",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "790 CHURCH ST NE STE 300",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300608940",
            "telephone_number": "770-422-3290",
            "fax_number": "770-422-0287"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "790 CHURCH ST NE STE 300",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300608940",
            "telephone_number": "770-422-3290",
            "fax_number": "770-422-0287"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERIBONIO",
        "first_name": "MIKAELA",
        "middle_name": "M",
        "credential": "AGNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-19",
        "last_updated": "2025-11-20",
        "certification_date": "2025-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "GA",
            "license": "RN291729",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "GA",
            "license": "NP291729",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sasha Perez-Garreaud
• Adacelis Perez
• Ana Maria Perez, MD
• David R. Perez, D.C.
• Irene Branco Perez, D.C.
• Perimeter Dental East Cobb
• Perimeter Rehabilitation Center, Inc.
• Amanda Perkins
• Shunesa Perkins, CRNP
• Allyson Katheryn Perko, APRN

• Gerontology Nurse Practitioner in Marietta, GA
• Providers in Marietta, GA by specialty
• Gerontology Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2025; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.