NORTHEAST FAMILY PRACTICE P.C
NPI 1396099578
Clinic/Center - Primary Care in Norcross, GA
About Northeast Family Practice P.c NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
NORTHEAST FAMILY PRACTICE P.C (NPI 1396099578) is a healthcare organization registered as a primary care in Norcross, Georgia and active in the NPI registry since November 2012. The organization holds a CLIA Waiver certificate valid through April 6, 2028 and lists Regina Jianhua Wang, President, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Identifiers 2
Accepted 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)
Northeast Family Practice P.c 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 Northeast Family Practice P.C, which bills Medicare for the services this clinician delivers.
Clinician (1)
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 11D2341694
Northeast Family Practice PC · Duluth, GAFrequently 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 Northeast Family Practice P.C's NPI number?
The NPI number for Northeast Family Practice P.C is 1396099578. It was assigned to this organization in the NPPES registry on November 9, 2012.
Where is Northeast Family Practice P.C located?
Northeast Family Practice P.C is located at 4720 Peachtree Industrial Blvd Ste 202, Norcross, GA 30071. The listed phone number is (770) 514-8880.
What is Northeast Family Practice P.C's specialty?
The primary specialty registered for this NPI is Clinic/Center, specializing in Primary Care, with taxonomy code 261QP2300X.
Is Northeast Family Practice P.C enrolled in Medicare?
Yes. Northeast Family Practice P.C is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Northeast Family Practice P.C?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Family Practice) reassigns their Medicare billing to Northeast Family Practice P.C. 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.
Does Northeast Family Practice P.C hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 11D2341694) is associated with this NPI, valid through April 6, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
What insurance does Northeast Family Practice P.C accept?
Health plans from Ambetter Health list Northeast Family Practice P.C 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 Northeast Family Practice P.C was last updated on October 19, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 27 days 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.
# Northeast Family Practice P.c · NPI 1396099578
Primary Care organization in Norcross, Georgia. Organization record, active in the CMS NPPES registry since November 9, 2012.
## Identity
- **NPI:** 1396099578 (Entity type: Organization)
- **Enumerated:** November 9, 2012
- **Primary specialty:** Clinic/Center - Primary Care · taxonomy 261QP2300X
- **Organization subpart:** No
- **Authorized official:** Regina Wang, PRESIDENT
## Practice location
- **Address:** 4720 PEACHTREE INDUSTRIAL BLVD, STE 202, Norcross, GA 30071-5735
- **Phone:** (770) 514-8880
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 1 clinician (Family Practice) reassigns Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** October 19, 2026
- **Other identifiers:** Other 08BBWJW (GA); Medicaid 00951475A (GA)
- **CLIA laboratory certificates:** 1 on file
---
Source: [NPI Profile](https://npiprofile.com/npi/1396099578) · Data from the CMS NPPES public registry.