MRS. QUYEN LE TA (NP) – Nurse Practitioner, NPI 1003264250

MRS. QUYEN LE TA (NP) is a healthcare provider. based in Kennesaw, Georgia. specializing in NURSE PRACTITIONER. They hold the professional credentials NP. They hold a License No. RN211447 (GA). The NPI Number for MRS. QUYEN LE TA (NP) is 1003264250

Main info

Female
2 Years Of Experience
Accepts Medicare Assignment
Name
MRS. QUYEN LE TA (NP)
NPI
1003264250
Phone
(404) 324-9413
Address
2628 MYRTLEWOOD LN NW
Enumeration Date
28 May 2016
Last Update Date
25 September 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7702241000
Graduation Year
2024 (2 years ago)
PAC ID
3375836265
Group Practice PAC ID
0840291944
Professional Enrollment ID
I20160729002120
Address ID
GA301158015CA450XXBLVD400
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience49
Completeness85
Years active:10State licenses:1Digital endpointsOther names

9,652 NURSE PRACTITIONER in GA

Provider Addresses for MRS. QUYEN LE TA (NP)

  • 2628 MYRTLEWOOD LN NW

    KENNESAW, GA 301447395

    Phone: (404) 324-9413

    Type: Location

  • 2628 Myrtlewood Ln NW

    Kennesaw, GA 301447395

    Phone: (404) 324-9413

    Type: Location

  • 960 JOE FRANK HARRIS PKWY SE

    CARTERSVILLE, GA 301202129

    Phone: (470) 490-2142

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2016-07-29

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20160729002120INurse PractitionerGATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99223Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes7471$0
View full utilization report →

Insurance plans in this area (ZIP 30144)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 0840291944View full group profile
NameSpecialtyState
Internal MedicineGA
H O S P I T A L I S TGA
P S Y C H I A T R YGA
-GA
-GA
Hospice/Palliative Care, Hospitalist, Internal MedicineGA
Hospitalist, Internal MedicineGA
Hospitalist, Internal MedicineTN
-GA
H O S P I T A L I S TGA

Reviews

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Frequently asked questions

Is MRS. QUYEN LE TA (NP) listed with a National Provider Identifier?
Yes — MRS. QUYEN LE TA (NP) has NPI 1003264250 on file in the registry.
Is MRS. QUYEN LE TA (NP) still an active registrant?
MRS. QUYEN LE TA (NP) carries an active NPI according to the public dataset.
What expertise is attributed to MRS. QUYEN LE TA (NP)?
MRS. QUYEN LE TA (NP)'s specialty line reads Nurse Practitioner. Clinical services aligned with this taxonomy classification.
What practice footprint exists for MRS. QUYEN LE TA (NP)?
Travel planning: use Kennesaw, Georgia as the reference point for MRS. QUYEN LE TA (NP), then confirm.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

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