PCA INTERVENTIONAL SPINE AT FAYETTE, LLC – Pain Clinic/Center, NPI 1447791074
Pain Clinic/Center
Main info
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for PCA INTERVENTIONAL SPINE AT FAYETTE, LLC
1233 HIGHWAY 54 W
SUITE 205
FAYETTEVILLE, GA 302144542
Phone: (404) 351-7654
Type: Location
Peachtree Street, Brookwood, Atlanta, Fulton County, Georgia, 30309, United States
SUITE 750
ATLANTA, GA 303092519
Phone:
Type: Mailing
PO BOX 40061
BELFAST, ME 049151237
Phone: (678) 971-4167
Fax: (833) 989-2501
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.
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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: 2019-03-26
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Past revalidation due date
Earliest CMS due date was 2024-10-31 (588 days ago).
Enrollment records
1
Earliest due date
2024-10-31
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 |
|---|---|---|---|---|
| O20190326001044 | O | Ambulatory Surgical Center | GA | 2024-10-31 |
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.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 64483 | Injection of anesthetic and/or steroid drug into sacral spine nerve root using imaging guidance, single level | 386 | 175 | $0 |
| G0260 | Injection procedure for sacroiliac joint; provision of anesthetic, steroid and/or other therapeutic agent, with or without arthrography | 271 | 113 | $0 |
| 64493 | Injection of lower or sacral spine facet joint using imaging guidance, single level | 173 | 59 | $0 |
| 64635 | Destruction of lower or sacral spinal facet joint nerves using imaging guidance, single facet joint | 131 | 74 | $0 |
| 62321 | Injection of substance into middle or upper spine canal using imaging guidance | 51 | 36 | $0 |
Insurance plans in this area (ZIP 30214)
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