Individual provider Active NPI

Kristen Havrilla, PA-C

  • Physician Assistant
  • Sandy Springs, GA
National Provider Identifier
1902373343
Registry record updated Sep 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
12434 Issued in GA
Practice address
6660 Roswell Rd
Sandy Springs, GA 30328-3167
Phone
(404) 996-0195
Fax
(404) 531-0967
NPI assigned
Oct 24, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 022680 NY
Physician Assistant 363A00000X 12434 GA Primary

Addresses

Primary practice location

6660 Roswell Rd
Sandy Springs, GA 30328-3167

Mailing address

1007 Avery Creek Dr
Woodstock, GA 30188-2313
Phone (404) 791-3772

Other practice location 1

281 1st Ave
New York, NY 10003-2925
Phone (212) 420-2000

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
I20241122000413 GA Practitioner - Physician Assistant 6901142645 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wellstreet of Georgia PCGroup PAC ID 7517126279, 425 clinicians

Practice addresses (Care Compare)

1034 Old Peachtree Rd NW
Lawrenceville, GA 30043-3308
Phone (678) 335-5400

2292 Peachtree Rd
Atlanta, GA 30309-1147
Phone (404) 382-9941

2637 Peachtree Pkwy
Suwanee, GA 30024-1048
Phone (678) 660-5137

5438 Peachtree Blvd
Chamblee, GA 30341-2232
Phone (470) 816-0988

6660 Roswell Nerd
Sandy Springs, GA 30328-3167
Phone (404) 996-0195

Merit-based Incentive Payment System (MIPS)

Final score
86.33 of 100Reported as group
Quality
82.1
Promoting interoperability
100
Improvement activities
40
Cost
72.34

Merit-based Incentive Payment System (MIPS)

Final score
91.62 of 100Reported as apm
Quality
83.25
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
12434GAMDPhysician Assistant
022680NYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
The Emory Clinic Inc CurrentSince Oct 6, 2025 Accepting new patients

Locations

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

Organizations & group practices 2

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": "1540339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757721600000",
    "number": "1902373343",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1007 AVERY CREEK DR",
            "city": "WOODSTOCK",
            "state": "GA",
            "postal_code": "301882313",
            "telephone_number": "404-791-3772"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6660 ROSWELL RD",
            "city": "SANDY SPRINGS",
            "state": "GA",
            "postal_code": "303283167",
            "telephone_number": "404-996-0195",
            "fax_number": "404-531-0967"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "281 1st Ave",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100032925",
            "country_code": "US",
            "telephone_number": "212-420-2000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HAVRILLA",
        "first_name": "KRISTEN",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-24",
        "last_updated": "2025-09-13",
        "certification_date": "2025-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "022680",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "12434",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sandy Springs, GA

Sources for this page

Verify at the official NPI Registry.