Individual provider Active NPI

Allison Marie Guagliardo

  • Physician Assistant
  • Lawrenceville, GA
National Provider Identifier
1881417293
Registry record updated Feb 18, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
13772 Issued in GA
Practice address
2200 Medical Center Blvd Ste 320
Lawrenceville, GA 30046-7767
Phone
(951) 534-1010
NPI assigned
Nov 4, 2024
Last updated
Feb 18, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 18, 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 13772 GA Primary

Addresses

Primary practice location

2200 Medical Center Blvd Ste 320
Lawrenceville, GA 30046-7767

Mailing address

3179 Flowers Rd S Apt X
Atlanta, GA 30341-5674
Phone (951) 534-1010

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
I20260311004476 GA Practitioner - Physician Assistant 4880177484 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northside Surgical Professional Services LLCGroup PAC ID 8628253424, 367 clinicians

Practice addresses (Care Compare)

2200 Medical Ctr Blvd
Suite 320
Lawrenceville, GA 30046-7767
Phone (470) 325-1160

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
13772GAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Northside Surgical Professional Services LLC CurrentSince Feb 16, 2026 Accepting new patients

Locations

2200 Medical Center Blvd
Ste 320
Lawrenceville, GA 30046
Phone (470) 325-1160

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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": "1730678400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1771372800000",
    "number": "1881417293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3179 FLOWERS RD S APT X",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303415674",
            "telephone_number": "951-534-1010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 MEDICAL CENTER BLVD STE 320",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300467767",
            "telephone_number": "951-534-1010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUAGLIARDO",
        "first_name": "ALLISON",
        "middle_name": "MARIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-11-04",
        "last_updated": "2026-02-18",
        "certification_date": "2026-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "13772",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lawrenceville, GA

Sources for this page

Verify at the official NPI Registry.