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SHANDRA LUNETTE HART PA-C
NPI 1124611017
Physician Assistant in Riverdale, GA

Active since February 11, 2021PECOS Enrolled
116 UPPER RIVERDALE RD SW, RIVERDALE, GA 30274(404) 564-7042(404) 241-6256 Get Directions Write a Review

NPPES record last updated: November 20, 2023. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Nov 20, 2023, Nov 3, 2021, Feb 11, 2021 (3 updates tracked since 2021).

About Shandra Lunette Hart Pa-c NPPES

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

SHANDRA LUNETTE HART PA-C (NPI 1124611017) is an individual physician assistant in Riverdale, Georgia, licensed in Georgia (10236) and active in the NPI registry since February 2021. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1124611017
Entity TypeIndividualFemale
Primary Taxonomy363A00000X
Provider Legal NameSHANDRA LUNETTE HARTCredential: PA-C
Location Address116 UPPER RIVERDALE RD SWRiverdale, GA 30274-2527
Mailing Address1046 Ridge Ave SwAtlanta, GA 30315-1640 · (404) 688-1350 · Fax (470) 593-7784
Phone(404) 564-7042
Fax(404) 241-6256
Sole ProprietorYes
Enumeration DateFebruary 11, 2021
Last NPPES UpdateNovember 20, 20233 updates tracked since enumeration
NPPES CertifiedNovember 20, 2023
✔ NPI 1124611017 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
License✔ Licensed in GA · 10236
Definition
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.
116 UPPER RIVERDALE RD SW, Riverdale, GA 30274
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Shandra Lunette Hart Pa-c is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 30274 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$88.06 typical visit price
range $56.84 – $172.43
Typical copayment $22.01 (range $14.21 – $43.10)
Most-billed visit code 99203
Established Patient
$70.85 typical visit price
range $18.22 – $140.40
Typical copayment $17.71 (range $4.55 – $35.10)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

SOUTHSIDE MEDICAL CENTER, INC.
Clinic/Center (Federally Qualified Health Center (FQHC))
116 UPPER RIVERDALE RD SW
RIVERDALE, GA 30274
Clayton County (678) 834-7847

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 Shandra Hart's NPI number?

The NPI number for Shandra Hart is 1124611017. It was assigned to this individual provider in the NPPES registry on February 11, 2021.

Where is Shandra Hart located?

Shandra Hart practices at 116 Upper Riverdale Rd SW, Riverdale, GA 30274. The listed phone number is (404) 564-7042.

What is Shandra Hart's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Is Shandra Hart enrolled in Medicare?

Yes. Shandra Hart is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Shandra Hart was last updated on November 20, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.