Individual provider Active NPI

Elizabeth Grass, PA-C

  • Medical Physician Assistant
  • Gainesville, GA
National Provider Identifier
1861858623
Registry record updated Jun 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
7895 Issued in GA
Practice address
663 Lanier Park Dr
Gainesville, GA 30501-2059
Phone
(678) 450-0202
Fax
(678) 971-6065
NPI assigned
Jan 11, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 7895 GA Primary

Addresses

Primary practice location

663 Lanier Park Dr
Gainesville, GA 30501-2059

Mailing address

663 Lanier Park Dr
Gainesville, GA 30501-2059
Phone (678) 450-0202

Other practice location 1

638 Hay 441
Demorest, GA 30535
Phone (678) 450-0202 ext. 2034

Other practice location 2

1515 River Pl Ste 140
Braselton, GA 30517-5603
Phone (678) 450-0202 ext. 2034

Other practice location 3

4035 Johns Creek Pkwy Ste C
Suwanee, GA 30024-1213
Phone (678) 450-0202 ext. 2034

Other practice location 4

101 Greenfield Dr Ste 240
Cumming, GA 30040-3174
Phone (678) 450-0202

Other identifiers 1

IdentifierTypeStateIssuer
003173185MedicaidGA

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
I20160215002838 GA Practitioner - Physician Assistant 4284938051 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Emory University School of Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kidney Care Center of Georgia LLCGroup PAC ID 9638200819, 24 clinicians

Practice addresses (Care Compare)

101 Greenfield Dr
Suite 240
Cumming, GA 30040-2727
Phone (678) 450-0202

4035 Johns Creek Pkwy
Suite C
Suwanee, GA 30024-1213
Phone (678) 450-0202

4630 Valais CT
Johns Creek, GA 30022-6656
Phone (678) 450-0202

663 Lanier Park Dr
Gainesville, GA 30501-2059
Phone (678) 450-0202

81 Northside Dawson Dr
Suite 315
Dawsonville, GA 30534-7166
Phone (678) 450-0202

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
7895GAMDMedical Physician Assistant

Interoperability endpoints

  • Direct secure messaging: egrass16872@direct.acumenmd.com

Organizations & group practices 1

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.

Hospital & facility affiliations 3

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": "1452470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750204800000",
    "number": "1861858623",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "663 LANIER PARK DR",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305012059",
            "telephone_number": "678-450-0202",
            "fax_number": "678-971-6065"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "663 LANIER PARK DR",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305012059",
            "telephone_number": "678-450-0202",
            "fax_number": "678-971-6065"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "638 Hay 441",
            "address_purpose": "LOCATION",
            "city": "Demorest",
            "state": "GA",
            "postal_code": "30535",
            "country_code": "US",
            "telephone_number": "678-450-0202 x2034",
            "fax_number": "678-971-6065",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1515 River Pl Ste 140",
            "address_purpose": "LOCATION",
            "city": "Braselton",
            "state": "GA",
            "postal_code": "305175603",
            "country_code": "US",
            "telephone_number": "678-450-0202 x2034",
            "fax_number": "678-971-6065",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4035 Johns Creek Pkwy Ste C",
            "address_purpose": "LOCATION",
            "city": "Suwanee",
            "state": "GA",
            "postal_code": "300241213",
            "country_code": "US",
            "telephone_number": "678-450-0202 x2034",
            "fax_number": "678-971-6065",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "101 Greenfield Dr Ste 240",
            "address_purpose": "LOCATION",
            "city": "Cumming",
            "state": "GA",
            "postal_code": "300403174",
            "country_code": "US",
            "telephone_number": "678-450-0202",
            "fax_number": "678-450-0080",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRASS",
        "first_name": "ELIZABETH",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-01-11",
        "last_updated": "2025-06-18",
        "certification_date": "2025-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "GA",
            "license": "7895",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003173185",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gainesville, GA

Sources for this page

Verify at the official NPI Registry.