Peachtree Plastic Surgery

Primary specialty

SpecialistTaxonomy code 174400000X

License

047345 Issued in GA

Legal business name

PEACHTREE PLASTIC SURGERY

Practice address

3286 Northside Pkwy NW Ste 1000
Atlanta, GA 30327-2294

Phone

(404) 841-8450

Fax

(404) 841-8453

NPI assigned

Aug 31, 2006

Last updated

Jun 30, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Grace Y Ma, MDNPI 1992707335

Title

Ceo, Owner

Phone

(404) 841-8450

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Locations

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Grace Yu-Chun Ma, M. D.

  • Plastic and Reconstructive Surgery Physician
  • Atlanta, GA
  • NPI 1992707335
  Medicare reassignment Care Compare group NPD Authorized official
• Drew Metcalfe, M.D.

  • Plastic Surgery Physician
  • Atlanta, GA
  • NPI 1689930331
  Medicare reassignment Care Compare group NPD
• Peter W Thompson, MD

  • Plastic Surgery Physician
  • Atlanta, GA
  • NPI 1194902288
  Medicare reassignment Care Compare group NPD
• Samantha Margrit Cummins

  • Plastic Surgery Physician
  • Dallas, TX
  • NPI 1215434162

  GA

  Medicare reassignment Care Compare group NPD
• Thao Ngo, PA-C

  • Physician Assistant
  • Atlanta, GA
  • NPI 1558254573
  NPD
• Russell Lee Ashinoff, M.D.

  • Plastic and Reconstructive Surgery Physician
  • Brick, NJ
  • NPI 1831152719
  NPD
• Lauren Elizabeth Boag, PA

  • Surgical Physician Assistant
  • Atlanta, GA
  • NPI 1831902923
  NPD (past)
• Kristin A Boehm, M.D.

  • Plastic and Reconstructive Surgery Physician
  • Atlanta, GA
  • NPI 1093713208
  NPD (past)
• Rachel Bryan, NP

  • Plastic Surgery Physician
  • Atlanta, GA
  • NPI 1396347571
  NPD (past)
• Lindsey Kyle Smith

  • Family Nurse Practitioner
  • Atlanta, GA
  • NPI 1124416623
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1656547200000",
    "number": "1972614832",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3286 NORTHSIDE PKWY NW STE 1000",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303272294",
            "telephone_number": "404-841-8450",
            "fax_number": "404-841-8453"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3286 NORTHSIDE PKWY NW STE 1000",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303272294",
            "telephone_number": "404-841-8450",
            "fax_number": "404-841-8453"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEACHTREE PLASTIC SURGERY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-31",
        "last_updated": "2022-06-30",
        "certification_date": "2022-06-30",
        "status": "A",
        "authorized_official_last_name": "MA",
        "authorized_official_first_name": "GRACE",
        "authorized_official_middle_name": "Y",
        "authorized_official_title_or_position": "CEO, OWNER",
        "authorized_official_telephone_number": "404-841-8450",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "GA",
            "license": "047345",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000947383A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Peachtree Orthopaedic Surgery Center at Piedmont LLC (Peachtree Orthopeadic Surgery Center)
• Peachtree Park Pediatrics, LLP
• Peachtree Pediatric Psychology, LLC
• Peachtree Physical Medicine Group
• Peachtree Piedmont Pathology PC
• Peachtree Psychiatric Professionals PC
• Peachtree Psychiatric Professionals, PC
• Peachtree Psychiatry LLC (Nithyasri LLC)
• Peachtree Psychiatry of Atlanta Inc
• Peachtree Psychological Services, P.C.

• Specialist in Atlanta, GA
• Providers in Atlanta, GA by specialty
• Specialist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.