Individual provider Active NPI

Noel Gusman Ferrer, PA-C

  • Physician Assistant
  • Roswell, GA
National Provider Identifier
1992065478
Registry record updated Aug 21, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
7804 Issued in GA
Practice address
1825 Old Alabama Rd Ste 201
Roswell, GA 30076-2258
Phone
(770) 393-9000
Fax
(770) 393-9006
NPI assigned
May 18, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2017

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 7804 GA Primary

Addresses

Primary practice location

1825 Old Alabama Rd Ste 201
Roswell, GA 30076-2258

Mailing address

151 Southhall LN
Ste 300
Maitland, FL 32751-7172
Phone (407) 875-2080

Other identifiers 1

IdentifierTypeStateIssuer
1102950OtherFLNCCPA

Other names 1

  • Noel Gusman Former name

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
I20160210001810 GA Practitioner - Physician Assistant 4981908076 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Advanced Dermatology of Georgia, LLCGroup PAC ID 9638485782, 15 clinicians

Practice addresses (Care Compare)

771 Old Norcross Rd
Suite 260
Lawrenceville, GA 30046-4981
Phone (770) 962-5040

Merit-based Incentive Payment System (MIPS)

Final score
94.02 of 100Reported as group
Quality
88.03
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
7804GAMDPhysician Assistant

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1337299200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1503273600000",
    "number": "1992065478",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "151 SOUTHHALL LN",
            "address_2": "STE 300",
            "city": "MAITLAND",
            "state": "FL",
            "postal_code": "327517172",
            "telephone_number": "407-875-2080",
            "fax_number": "407-650-3455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1825 OLD ALABAMA RD STE 201",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "300762258",
            "telephone_number": "770-393-9000",
            "fax_number": "770-393-9006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FERRER",
        "first_name": "NOEL",
        "middle_name": "GUSMAN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-05-18",
        "last_updated": "2017-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "7804",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCCPA",
            "identifier": "1102950",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NOEL",
            "last_name": "GUSMAN",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Roswell, GA

Sources for this page

Verify at the official NPI Registry.