STANISLAV KOZLOVSKI (PA-C) – Medical Physician Assistant, NPI 1437767910
Medical Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
4,430 PHYSICIAN ASSISTANT in GA
Provider Addresses for STANISLAV KOZLOVSKI (PA-C)
1058 BEAR CREEK BLVD
HAMPTON, GA 302281849
Phone: (770) 707-0808
Type: Mailing
3280 PEACHTREE RD NE STE 115
ATLANTA, GA 303052433
Phone: (888) 663-6331
Fax: (415) 252-7176
Type: Location
5165 PEACHTREE PKWY # 1300B
PEACHTREE CORNERS, GA 300922523
Phone: (888) 663-6331
Fax: (404) 999-7964
Type: Location
1 EMBARCADERO CTR STE 1900
SAN FRANCISCO, CA 941113723
Phone: (415) 658-6791
Fax: (415) 252-7176
Type: Mailing
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: 2020-09-29
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20200929000305 | I | Physician Assistant | GA | TBD |
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.
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.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 30228)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Family Practice | GA | |
| Nurse Practitioner | MS | |
| Physician Assistant | GA | |
| Family Practice | GA | |
| Family Practice | GA | |
| Physician Assistant | CA | |
| Physician Assistant | MA | |
| Physician Assistant | NY | |
| Physician Assistant | GA | |
| Family Practice | SC |
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