1. Home
  2. Directory
  3. Georgia
  4. Duluth
  5. Specialist
  6. NPI Profile

PRIMA CENTER FOR PLASTIC SURGERY PC
NPI 1114065935
Specialist in Duluth, GA

Active since February 02, 2007CLIA 11D2310418 · Waiver
3096 PEACHTREE INDUSTRIAL BLVD, DULUTH, GA 30097(770) 495-1477(770) 495-1488 Get Directions Write a Review

NPPES record last updated: March 13, 2013. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Prima Center For Plastic Surgery Pc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PRIMA CENTER FOR PLASTIC SURGERY PC (NPI 1114065935) is a healthcare organization registered as a specialist in Duluth, Georgia and active in the NPI registry since February 2007. The organization holds a CLIA Waiver certificate valid through September 3, 2028 and lists Phillip H Nakano, Doctor, as its authorized official.

NPPES Registry Identity

NPI1114065935
Entity TypeOrganization
Primary Taxonomy174400000X
Legal Business NamePRIMA CENTER FOR PLASTIC SURGERY PC
Location Address3096 PEACHTREE INDUSTRIAL BLVDDuluth, GA 30097-7918
Mailing Address3096 Peachtree Industrial BlvdDuluth, GA 30097-7918 · (770) 495-1477 · Fax (770) 495-1488
Phone(770) 495-1477
Fax(770) 495-1488
Organization SubpartNo
Authorized OfficialPhillip H NakanoDoctor · (770) 495-1477
Enumeration DateFebruary 2, 2007
Last NPPES UpdateMarch 13, 2013
✔ NPI 1114065935 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySpecialistOther Service Providers
Taxonomy Code174400000X
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
3096 PEACHTREE INDUSTRIAL BLVD, Duluth, GA 30097
Open in Google Maps ↗

Other Identifiers 2

Medicare ID-Type UnspecifiedGRP630GA
Medicaid55001192AGA

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Alliant Health Plans, Inc..Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Prima Center For Plastic Surgery Pc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

4

Medicare enrollment records show 4 clinicians reassign Medicare billing to Prima Center For Plastic Surgery PC, which bills Medicare for the services they deliver. Of these, 3 practice at this address. They are listed nearest first.

Clinicians, nearest first (4)

Aniket Sakharpe, M.D.
Plastic and Reconstructive Surgery
NPI 1720399967
3096 PEACHTREE INDUSTRIAL BLVD
Duluth, GA 30097
(404) 649-5256
✔ PECOS✔ Accepts MedicareSame address
Hanjoon Song, MD
Plastic and Reconstructive Surgery
NPI 1063502375
3096 PEACHTREE INDUSTRIAL BLVD
Duluth, GA 30097
(770) 495-1477
✔ PECOS✔ Accepts MedicareSame address
Phillip Nakano, M.D.
Plastic and Reconstructive Surgery
NPI 1962502252
3096 PEACHTREE INDUSTRIAL BLVD
Duluth, GA 30097
(770) 495-1477
✔ PECOSSame address
Pallavi Kumbla, MD
Plastic and Reconstructive Surgery
NPI 1134462534
4150 DEPUTY BILL CANTRELL MEMORIAL ROAD SUITE 240
Cumming, GA 30040
(678) 931-8874
✔ PECOS✔ Accepts Medicare11 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 11D2310418

Prima Center For Plastic Surgery · Duluth, GA
Active · expires Sep 3, 2028
CLIA Number11D2310418
Laboratory TypeAmbulatory Surgery Center
Certificate Effective DateSeptember 4, 2026
Certificate Expiration DateSeptember 3, 2028
Laboratory DirectorHanjoon Song
Laboratory Phone(770) 495-1477
Laboratory LocationPrima Center For Plastic Surgery3096 Peachtree Industrial Blvd, Duluth, GA 30097
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Prima Center For Plastic Surgery PC's NPI number?

The NPI number for Prima Center For Plastic Surgery PC is 1114065935. It was assigned to this organization in the NPPES registry on February 2, 2007.

Where is Prima Center For Plastic Surgery PC located?

Prima Center For Plastic Surgery PC is located at 3096 Peachtree Industrial Blvd, Duluth, GA 30097. The listed phone number is (770) 495-1477.

What is Prima Center For Plastic Surgery PC's specialty?

The primary specialty registered for this NPI is Specialist with taxonomy code 174400000X.

Is Prima Center For Plastic Surgery PC enrolled in Medicare?

Yes. Prima Center For Plastic Surgery PC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Prima Center For Plastic Surgery PC?

According to the CMS Revalidation Reassignment List (October 2026 release), 4 clinicians, all in Plastic and Reconstructive Surgery, reassign their Medicare billing to Prima Center For Plastic Surgery PC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Of these, 3 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Prima Center For Plastic Surgery PC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 11D2310418) is associated with this NPI, valid through September 3, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Prima Center For Plastic Surgery PC accept?

Health plans from Alliant Health Plans, Inc. list Prima Center For Plastic Surgery PC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Prima Center For Plastic Surgery PC was last updated on March 13, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.