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SUSAN GAIL STAVISS M.D.
NPI 1346242229
Pediatrics - Adolescent Medicine in Marietta, GA

Active since August 11, 2005PECOS Enrolled
3939 ROSWELL RD, SUITE 300, MARIETTA, GA 30062(770) 578-2868(770) 971-8499 Get Directions Write a Review

NPPES record last updated: October 2, 2019. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Susan Gail Staviss M.d. NPPES

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

SUSAN GAIL STAVISS M.D. (NPI 1346242229) is an individual adolescent medicine provider in Marietta, Georgia, licensed in Georgia (038652) and active in the NPI registry since August 2005. She is enrolled in Medicare PECOS and maintains a secondary practice location in Kennesaw.

NPPES Registry Identity

NPI1346242229
Entity TypeIndividualFemale
Primary Taxonomy2080A0000X
Provider Legal NameSUSAN GAIL STAVISSCredential: M.D.
Location Address3939 ROSWELL RD, SUITE 300Marietta, GA 30062-6251
Mailing Address3939 Roswell Rd, Suite 300Marietta, GA 30062-6251 · (770) 578-2868 · Fax (770) 971-8499
Phone(770) 578-2868
Fax(770) 971-8499
Sole ProprietorNo
Enumeration DateAugust 11, 2005
Last NPPES UpdateOctober 2, 2019
✔ NPI 1346242229 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatrics · Adolescent MedicineAllopathic & Osteopathic Physicians
Taxonomy Code2080A0000X
License✔ Licensed in GA · 038652
Definition
A pediatrician who specializes in adolescent medicine is a multi-disciplinary healthcare specialist trained in the unique physical, psychological and social characteristics of adolescents, their healthcare problems and needs.
3939 ROSWELL RD, Marietta, GA 30062
Open in Google Maps ↗

Secondary Practice Location 1

Location 1205 Hawkins Store Rd NW Ste B1Kennesaw, GA 30144-6215 · Phone (770) 928-0862

Other Identifiers 4

Other3308662027GA · Cigna
Medicaid000607703DGA
Other241020GA · Private Healthcare System
Other4508167GA · Aetna Ushealthcare

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Alliant Health Plans, Inc., Ambetter from Absolute Total Care, Ambetter Health and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Susan Gail Staviss M.d. 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.

Medicare Billing Reassignment

Medicare enrollment records show Susan Staviss reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Wellstar Medical Group, LLC
Same address
Geriatric Medicine
3939 ROSWELL RD, SUITE 240
Marietta, GA 30062
  • Reassigned Medicare billing, Georgia enrollment
  • 3,885 clinicians in this Medicare group
NPI 1275814964 (678) 403-4660

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

Other Providers at the Same Location NPPES 11

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

TANYA THERIOT, PSY.D., P.C.
Psychologist
3939 ROSWELL RD, SUITE 185
MARIETTA, GA 30062
Cobb County (770) 310-1792
WELLSTAR MEDICAL GROUP, LLC
Family Medicine (Geriatric Medicine)
3939 ROSWELL RD, SUITE 240
MARIETTA, GA 30062
Cobb County (678) 403-4660
CHRISTINE GHILAIN PHD
Clinical Neuropsychologist
3939 ROSWELL RD
MARIETTA, GA 30062
Cobb County (770) 514-6760
MARIETTA EYE CLINIC, PA
Ophthalmology
3939 ROSWELL RD, SUITE 100
MARIETTA, GA 30062
Cobb County (770) 977-8000
DR. SONA P AMIN MD
Internal Medicine (Endocrinology, Diabetes & Metabolism)
3939 ROSWELL RD, SUITE 110
MARIETTA, GA 30062
Cobb County (678) 403-4300
ALICE PFEIFFER NIX P.T.
Physical Therapist
3939 ROSWELL RD, SUITE 160
MARIETTA, GA 30062
Cobb County (770) 971-5244
WELLSTAR MEDICAL GROUP, LLC
Pediatrics
3939 ROSWELL RD, SUITE 300
MARIETTA, GA 30062
Cobb County (770) 509-1234
SOUTHEAST INTEGRATIVE MEDICINE
Naturopath
3939 ROSWELL RD, SUITE 240
MARIETTA, GA 30062
Cobb County (678) 671-3100

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 Susan Staviss's NPI number?

The NPI number for Susan Staviss is 1346242229. It was assigned to this individual provider in the NPPES registry on August 11, 2005.

Where is Susan Staviss located?

Susan Staviss practices at 3939 Roswell Rd Suite 300, Marietta, GA 30062. The listed phone number is (770) 578-2868.

What is Susan Staviss's specialty?

The primary specialty registered for this NPI is Pediatrics, specializing in Adolescent Medicine, with taxonomy code 2080A0000X.

Is Susan Staviss enrolled in Medicare?

Yes. Susan Staviss is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Susan Staviss's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Susan Staviss reassigns Medicare benefits to Wellstar Medical Group, LLC (Marietta, GA). The 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 Susan Staviss's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Susan Staviss accept?

Health plans from Alliant Health Plans, Inc., Ambetter Health, Ambetter from Absolute Total Care, Ambetter of Alabama and Ambetter of North Carolina and 2 other insurers list Susan Staviss 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 Susan Staviss was last updated on October 2, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.