PROF. JOHN MARK LIDELL (M.M.SC. , PA-C) – Physician Assistant, NPI 1962487538
Physician Assistant
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Profile Insights
NPPES metrics only — not quality of care.
4,430 PHYSICIAN ASSISTANT in GA
Provider Addresses for PROF. JOHN MARK LIDELL (M.M.SC. , PA-C)
101, Yorktown Drive, Deep Forest, Fayetteville, Fayette County, Georgia, 30214, United States
SUITE 110
FAYETTEVILLE, GA 302141578
Phone: (678) 364-5400
Fax: (770) 460-4045
Type: Mailing
913 Eagles Landing Pkwy Ste 150
Stockbridge, GA 302815011
Phone: (770) 692-5910
Fax: (770) 692-5916
Type: Location
3576 Highway 138 SE
Stockbridge, GA 302817909
Phone: (770) 474-7448
Fax: (770) 474-7194
Type: Location
110, Regency Park Drive, McDonough, Henry County, Georgia, 30253, United States
MCDONOUGH, GA 302537076
Phone: (404) 996-0126
Fax: (678) 432-2626
Type: Location
3576 HIGHWAY 138 SE
STOCKBRIDGE, GA 302817909
Phone: (770) 474-7448
Fax: (770) 474-7194
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 1 Open Payments records for all available years, with a total value of $124.
Total Amount is formed as General ($124) + Research ($0) + Ownership ($0) = $124.
Last reported payment date: 2023-11-08 • Largest payer in this snapshot: Horizon Therapeutics plc ($124).
Total Amount
$124
General + Research + Ownership
Payments
1
Total payment records
General Amount
$124
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2023-11-08
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Horizon Therapeutics plc | $124 |
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: 2008-06-19
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 |
|---|---|---|---|---|
| I20080619000285 | 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.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 61 | 47 | $0 |
| 87428 | Detection test by immunoassay technique for severe acute respiratory syndrome coronavirus and influenza | 44 | 42 | $0 |
| 96372 | Injection of drug or substance under skin or into muscle | 35 | 23 | $0 |
| 99203 | New patient office or other outpatient visit, 30-44 minutes | 31 | 31 | $0 |
| 81003 | Automated urinalysis test | 26 | 21 | $0 |
Insurance plans in this area (ZIP 30214)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | GA | |
| - | GA | |
| - | GA | |
| R H E U M A T O L O G Y | MI | |
| Hospitalist, Internal Medicine | GA | |
| Nurse Practitioner | TN | |
| Family Practice | GA | |
| Physician Assistant | GA | |
| Physician Assistant | GA | |
| Hospitalist, Internal Medicine | GA |
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