JEFF A D'AMBROSIO (PA-C) – Medical Physician Assistant, NPI 1457553927

JEFF A D'AMBROSIO (PA-C) is a healthcare provider. based in Canton, Georgia. specializing in PHYSICIAN ASSISTANT. They hold the professional credentials PA-C. They hold a License No. 004621 (GA). The NPI Number for JEFF A D'AMBROSIO (PA-C) is 1457553927

Main info

Male
21 Years Of Experience
Accepts Medicare Assignment
Name
JEFF A D'AMBROSIO (PA-C)
NPI
1457553927
Phone
(770) 345-6600
Address
215 RIVERSTONE DR
Enumeration Date
5 June 2007
Last Update Date
8 July 2007

Doctor Profile

Medical School Name
OTHER
Secondary Phone
4043647206
Graduation Year
2005 (21 years ago)
PAC ID
7618075243
Group Practice PAC ID
6204829013
Professional Enrollment ID
I20070606000135
Address ID
GA303051729AT3495XNEXX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience52
Completeness75
Years active:19State licenses:1Digital endpointsOther names

4,431 PHYSICIAN ASSISTANT in GA

Provider Addresses for JEFF A D'AMBROSIO (PA-C)

  • 215 RIVERSTONE DR

    CANTON, GA 301145256

    Phone: (770) 345-6600

    Fax: (770) 345-6611

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 22 Open Payments records for all available years, with a total value of $433.

Total Amount is formed as General ($433) + Research ($0) + Ownership ($0) = $433.

Last reported payment date: 2024-11-22 • Largest payer in this snapshot: GENZYME CORPORATION ($215).

Total Amount

$433

General + Research + Ownership

Payments

22

Total payment records

General Amount

$433

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-11-22

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

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: 2007-06-06

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
I20070606000135IPhysician AssistantGATBD

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
99213Established patient office or other outpatient visit, 20-29 minutes472339$0
95117Professional service for multiple injections of allergen45845$0
95165Professional service for preparation and provision of 1 or more antigens32023$0
69210Removal of impacted ear wax227158$0
99203New patient office or other outpatient visit, 30-44 minutes197197$0
View full utilization report →

Insurance plans in this area (ZIP 30114)

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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: 6204829013View full group profile

Reviews

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Frequently asked questions

What is the registry number for JEFF A D'AMBROSIO (PA-C)?
The registry entry for JEFF A D'AMBROSIO (PA-C) shows NPI 1457553927.
Is JEFF A D'AMBROSIO (PA-C) currently accepting referrals based on NPI status?
Registry metadata lists JEFF A D'AMBROSIO (PA-C) as active.
How should patients interpret JEFF A D'AMBROSIO (PA-C)'s specialty?
The extract shows Medical Physician Assistant for JEFF A D'AMBROSIO (PA-C). Clinical services aligned with this taxonomy classification.
Is JEFF A D'AMBROSIO (PA-C) tied to Canton, Georgia?
If you are local to Canton, Georgia, JEFF A D'AMBROSIO (PA-C) may be relevant to your search.
Who maintains JEFF A D'AMBROSIO (PA-C)'s record?
Providers certify NPPES data; CMS hosts the public file you are viewing.

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