Individual provider Active NPI

Michael E Leahy

  • Physician Assistant
  • Lawrenceville, GA
National Provider Identifier
1932899259
Registry record updated Apr 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
12935 Issued in GA
Practice address
771 Old Norcross Rd Ste 390
Lawrenceville, GA 30046-4324
Phone
(678) 957-0757
Fax
(678) 957-9597
NPI assigned
May 10, 2023
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 30, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician AssistantGroup: 193400000X SINGLE SPECIALTY GROUP 363A00000X
Physician Assistant 363A00000X 12935 GA Primary

Addresses

Primary practice location

771 Old Norcross Rd Ste 390
Lawrenceville, GA 30046-4324

Mailing address

3100 Interstate North Cir SE Ste 500
Atlanta, GA 30339-2296
Phone (770) 953-6929

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
I20250513001955 GA Practitioner - Physician Assistant 5496273534 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Lincoln Memorial University Medical Department, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Piedmont Orthopedics, LLCGroup PAC ID 4385963172, 191 clinicians

Practice addresses (Care Compare)

1800 Howell Mill Rd NW
Suite 200
Atlanta, GA 30318-0917
Phone (404) 352-1015

1968 Peachtree Rd NW
Atlanta, GA 30309-1281
Phone (404) 352-1053

3929 Peachtree Rd NE
Suite 250
Brookhaven, GA 30319-3374
Phone (404) 352-1053

620 Cherokee St NE
Suite 300
Marietta, GA 30060-7202
Phone (770) 635-1812

771 Old Norcross Rd
Suite 390
Lawrenceville, GA 30046-4324
Phone (678) 957-0757

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
12935GAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Orthoatlanta, LLC CurrentSince Apr 21, 2025 Accepting new patients
Orthoatlanta, LLC CurrentSince Apr 21, 2025 Accepting new patients

Locations

3100 Interstate North Cir SE
Ste 500
Atlanta, GA 30339
Phone (770) 953-6929

1265 Highway 54 W
Ste 308
Fayetteville, GA 30214
Phone (678) 216-0771

771 Old Norcross Rd
Ste 390
Lawrenceville, GA 30046
Phone (678) 957-0757

620 Cherokee St NE
Ste 300
Marietta, GA 30060
Phone (770) 635-1812

Organizations & group practices 4

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": "1683676800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745971200000",
    "number": "1932899259",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3100 INTERSTATE NORTH CIR SE STE 500",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303392296",
            "telephone_number": "770-953-6929"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "771 OLD NORCROSS RD STE 390",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300464324",
            "telephone_number": "678-957-0757",
            "fax_number": "678-957-9597"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEAHY",
        "first_name": "MICHAEL",
        "middle_name": "E",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-05-10",
        "last_updated": "2025-04-30",
        "certification_date": "2025-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "12935",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lawrenceville, GA

Sources for this page

Verify at the official NPI Registry.