NATHAN SCOTT LYCAN PA
NPI 1366755993
Physician Assistant - Medical in Atlanta, GA

Q: What is Nathan Lycan's NPI number?

The NPI number for Nathan Lycan is 1366755993. It was assigned to this individual provider in the NPPES registry on July 25, 2010.

Q: What is Nathan Lycan's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.

Q: When was this NPI record last updated?

The NPPES record for Nathan Lycan was last updated on September 20, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 22 months 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.

Active since July 25, 2010PECOS EnrolledAccepts Medicare Assignment

1968 PEACHTREE ROAD NW, ATLANTA, GA 30309(404) 605-2800(404) 351-5983 Get Directions Write a Review

NPPES record last updated: September 20, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Nathan Scott Lycan Pa NPPES

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

NATHAN SCOTT LYCAN PA (NPI 1366755993) is an individual medical provider in Atlanta, Georgia, licensed in Georgia (005811) and active in the NPI registry since July 2010. He is enrolled in Medicare PECOS, maintains a secondary practice location in San Francisco, and is a graduate of Emory University School Of Medicine (2009).

NPPES Registry Identity

NPI1366755993

Entity TypeIndividualMale

Primary Taxonomy363AM0700X

Provider Legal NameNATHAN SCOTT LYCANCredential: PA

Location Address1968 PEACHTREE ROAD NWAtlanta, GA 30309

Mailing Address275 Collier Rd Nw, Suite 500Atlanta, GA 30309-1709 · (404) 605-2800 · Fax (404) 351-5983

Phone(404) 605-2800

Fax(404) 351-5983

Sole ProprietorNo

Medical School CMSEmory University School Of MedicineGraduated 2009

Enumeration DateJuly 25, 2010

Last NPPES UpdateSeptember 20, 2024

NPPES CertifiedSeptember 20, 2024

✔ NPI 1366755993 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPhysician Assistant · MedicalPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363AM0700X

License✔ Licensed in GA · 005811

Also ListedPhysician AssistantTaxonomy 363A00000X · License 54202 (CA)

1968 PEACHTREE ROAD NW, Atlanta, GA 30309

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Secondary Practice Location 1

Location 11 Embarcadero Ctr Ste 1900San Francisco, CA 94111-3723 · Phone (888) 663-6331

Other Identifiers 1

Other005811GA · Ga License

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Nathan Scott Lycan Pa is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID4082891890

PECOS Enrollment IDI20170831003029

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.

Other Providers at the Same Location NPPES 20

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

WILLIAM O PRINCE MD

Anesthesiology