Atlantic Advanced Spine and Neurology Institute – Interventional Pain Medicine Physician, NPI 1023651312
Interventional Pain Medicine Physician
Main info
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for Atlantic Advanced Spine and Neurology Institute
426 Exchange Blvd, Ste 300
Bethlehem, GA 306203002
Phone: (770) 298-2467
Fax: (888) 815-1765
Type: Location
6325 Hospital Pkwy,
Johns Creek, GA 30097
Phone: (770) 298-2467
Fax: (888) 815-1765
Type: Location
2146 ROSWELL RD STE 108-324
MARIETTA, GA 300623802
Phone:
Type: Mailing
Peachtree Industrial Boulevard, Duluth, Gwinnett County, Georgia, 30518, United States
DULUTH, GA 300962806
Phone: (203) 691-0726
Type: Location
3651 PEACHTREE PKWY STE E-313
SUWANEE, GA 300246009
Phone: (470) 268-6980
Fax: (888) 815-1765
Type: Mailing
3925 JOHNS CREEK CT STE C2
SUWANEE, GA 300246618
Phone: (470) 268-6980
Fax: (888) 815-1765
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: 2023-12-14
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Past revalidation due date
Earliest CMS due date was 2025-10-31 (223 days ago).
Enrollment records
2
Earliest due date
2025-10-31
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 |
|---|---|---|---|---|
| O20200807002735 | O | Clinic/Group Practice | GA | 2025-10-31 |
| O20231214002942 | O | Physician - Neurology | GA | TBD |
What to do next
- Verify current status on the CMS Revalidation Lookup Tool immediately.
- Complete revalidation in PECOS or contact your Medicare Administrative Contractor (MAC).
- Overdue revalidation can lead to deactivation of Medicare billing privileges.
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 30620)
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