Individual provider Active NPI

Juvenal Bermudez, PA

  • Physician Assistant
  • Atlanta, GA
National Provider Identifier
1942899760
Registry record updated Apr 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
10066 Issued in GA
Practice address
275 Collier Rd NW Ste 300
Atlanta, GA 30309-1740
Phone
(404) 350-0009
Fax
(404) 350-0009
NPI assigned
Jan 15, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pulmonary Disease Physician 207RP1001X 10066 GA
Physician Assistant 363A00000X 10066 GA Primary

Addresses

Primary practice location

275 Collier Rd NW Ste 300
Atlanta, GA 30309-1740

Mailing address

275 Collier Rd NW Ste 300
Atlanta, GA 30309-1740
Phone (404) 350-0009

Other practice location 1

1968 Peachtree Rd NW
Atlanta, GA 30309-1281
Phone (404) 605-5478

Other practice location 2

2005 Mount Zion Rd
Morrow, GA 30260-3313
Phone (770) 919-5250

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
I20210323001969 GA Practitioner - Physician Assistant 3577970391 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of South Alabama College of Medicine, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Piedmont Specialty Hospital Billing LLCGroup PAC ID 4183986490, 252 clinicians

Practice addresses (Care Compare)

1133 Eagles Landing Pkwy
Stockbridge, GA 30281-5085
Phone (678) 604-1000

1255 Hwy 54 W
Fayetteville, GA 30214-4526
Phone (770) 719-7000

1412 Milstead Ave NE
Conyers, GA 30012-3877
Phone (770) 918-3000

1968 Peachtree Rd NW
Atlanta, GA 30309-1281
Phone (404) 605-5000

5126 Hospital Dr NE
Covington, GA 30014-2566
Phone (770) 786-7053

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
10066GAMDPulmonary Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Choa Multispecialty, LLC Current Accepting new patients
Peachtree Immediate Care UC, LLC PastSince Jan 1, 2021 Accepting new patients

Locations

1405 Clifton Rd NE
Atlanta, GA 30322
Phone (404) 785-1112

1968 Ptree Rd NW
Atlanta, GA 30309
Phone (404) 605-2222

1133 Eagles Landing Pkwy
Stockbridge, GA 30281
Phone (678) 604-1000

Organizations & group practices 6

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 4

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": "1610668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745798400000",
    "number": "1942899760",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "275 COLLIER RD NW STE 300",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303091740",
            "telephone_number": "404-350-0009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "275 COLLIER RD NW STE 300",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303091740",
            "telephone_number": "404-350-0009",
            "fax_number": "404-350-0009"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1968 Peachtree Rd NW",
            "address_purpose": "LOCATION",
            "city": "Atlanta",
            "state": "GA",
            "postal_code": "303091281",
            "country_code": "US",
            "telephone_number": "404-605-5478",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2005 Mount Zion Rd",
            "address_purpose": "LOCATION",
            "city": "Morrow",
            "state": "GA",
            "postal_code": "302603313",
            "country_code": "US",
            "telephone_number": "770-919-5250",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BERMUDEZ",
        "first_name": "JUVENAL",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-01-15",
        "last_updated": "2025-04-28",
        "certification_date": "2025-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "GA",
            "license": "10066",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "10066",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.