MARIETTA PLASTIC SURGERY
NPI 1316165723
Surgery - Plastic and Reconstructive Surgery in Marietta, GA

Active since April 23, 2007
823 CAMPBELL HILL ST NW, MARIETTA, GA 30060(770) 425-0118(770) 426-1626 Get Directions Write a Review

NPPES record last updated: July 21, 2022. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Marietta Plastic Surgery NPPES

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

MARIETTA PLASTIC SURGERY (NPI 1316165723) is a healthcare organization registered as a plastic and reconstructive surgery in Marietta, Georgia and active in the NPI registry since April 2007. The organization lists Donna Marie Bockhorst, Practice Administrator, as its authorized official.

NPPES Registry Identity

NPI1316165723
Entity TypeOrganization
Primary Taxonomy2086S0122X
Legal Business NameMARIETTA PLASTIC SURGERY
Location Address823 CAMPBELL HILL ST NWMarietta, GA 30060-1144
Mailing Address823 Campbell Hill St NwMarietta, GA 30060-1144 · (770) 425-0118 · Fax (770) 426-1626
Fax(770) 426-1626
Organization SubpartNo
Authorized OfficialDonna Marie BockhorstPractice Administrator · (770) 425-0118
Enumeration DateApril 23, 2007
Last NPPES UpdateJuly 21, 2022
✔ NPI 1316165723 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySurgery · Plastic and Reconstructive SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code2086S0122X
Definition
A surgeon who specializes in plastic and reconstructive surgery.
823 CAMPBELL HILL ST NW, Marietta, GA 30060

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

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Marietta Plastic Surgery is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Marietta Plastic Surgery, which bills Medicare for the services this clinician delivers.

Clinician (1)

Plastic and Reconstructive Surgery
NPI 1275705188
823 CAMPBELL HILL ST NW
Marietta, GA 30060
(770) 425-0118
✔ PECOS✔ Accepts MedicareSame address

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

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 Marietta Plastic Surgery's NPI number?

The NPI number for Marietta Plastic Surgery is 1316165723. It was assigned to this organization in the NPPES registry on April 23, 2007.

Where is Marietta Plastic Surgery located?

Marietta Plastic Surgery is located at 823 Campbell Hill St NW, Marietta, GA 30060. The listed phone number is (770) 425-0118.

What is Marietta Plastic Surgery's specialty?

The primary specialty registered for this NPI is Surgery, specializing in Plastic and Reconstructive Surgery, with taxonomy code 2086S0122X.

Is Marietta Plastic Surgery enrolled in Medicare?

Yes. Marietta Plastic Surgery is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Marietta Plastic Surgery?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Plastic and Reconstructive Surgery) reassigns their Medicare billing to Marietta Plastic Surgery. 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. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Marietta Plastic Surgery was last updated on July 21, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.