1. Home
  2. Directory
  3. Georgia
  4. Augusta
  5. Plastic Surgery
  6. NPI Profile

MAGNOLIA LANE PLASTIC SURGERY, LLC
NPI 1659139590
Plastic Surgery in Augusta, GA

Active since March 06, 2024
3633 WHEELER RD STE 110, AUGUSTA, GA 30909(706) 723-1632(706) 869-3841 Get Directions Write a Review

NPPES record last updated: August 26, 2024. Verified against the NPPES registry weekly; last sync: November 08, 2026.

Record update history: Aug 22, 2024, Mar 6, 2024 (2 updates tracked since 2024).

About Magnolia Lane Plastic Surgery, Llc NPPES

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

MAGNOLIA LANE PLASTIC SURGERY, LLC (NPI 1659139590) is a healthcare organization registered as a plastic surgery in Augusta, Georgia and active in the NPI registry since March 2024. The organization lists Taylor Cato, Office Manager, as its authorized official.

NPPES Registry Identity

NPI1659139590
Entity TypeOrganization
Primary Taxonomy208200000X
Legal Business NameMAGNOLIA LANE PLASTIC SURGERY, LLC
Location Address3633 WHEELER RD STE 110Augusta, GA 30909-6544
Mailing Address607 Ronald Reagan Dr Unit 724Evans, GA 30809-7729
Phone(706) 723-1632
Fax(706) 869-3841
Organization SubpartNo
Authorized OfficialTaylor CatoOffice Manager · (706) 723-1632
Enumeration DateMarch 6, 2024
Last NPPES UpdateAugust 26, 20242 updates tracked since enumeration
NPPES CertifiedAugust 26, 2024
✔ NPI 1659139590 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPlastic SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code208200000X
Definition
A plastic surgeon deals with the repair, reconstruction or replacement of physical defects of form or function involving the skin, musculoskeletal system, craniomaxillofacial structures, hand, extremities, breast and trunk and external genitalia or cosmetic enhancement of these areas of the body. Cosmetic surgery is an essential component of plastic surgery. The plastic surgeon uses cosmetic surgical principles to both improve overall appearance and to optimize the outcome of reconstructive procedures. The surgeon uses aesthetic surgical principles not only to improve undesirable qualities of normal structures but in all reconstructive procedures as well.
3633 WHEELER RD STE 110, Augusta, GA 30909
Open in Google Maps ↗

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)

Magnolia Lane Plastic Surgery, Llc 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 Magnolia Lane Plastic Surgery, LLC, which bills Medicare for the services this clinician delivers.

Clinician (1)

Manuel Medina, M.D.
Plastic and Reconstructive Surgery
NPI 1558651935
3633 WHEELER RD STE 110
Augusta, GA 30909
(706) 723-1632
✔ 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 Magnolia Lane Plastic Surgery, LLC's NPI number?

The NPI number for Magnolia Lane Plastic Surgery, LLC is 1659139590. It was assigned to this organization in the NPPES registry on March 6, 2024.

Where is Magnolia Lane Plastic Surgery, LLC located?

Magnolia Lane Plastic Surgery, LLC is located at 3633 Wheeler Rd Ste 110, Augusta, GA 30909. The listed phone number is (706) 723-1632.

What is Magnolia Lane Plastic Surgery, LLC's specialty?

The primary specialty registered for this NPI is Plastic Surgery with taxonomy code 208200000X.

Is Magnolia Lane Plastic Surgery, LLC enrolled in Medicare?

Yes. Magnolia Lane Plastic Surgery, LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Magnolia Lane Plastic Surgery, LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Plastic and Reconstructive Surgery) reassigns their Medicare billing to Magnolia Lane Plastic Surgery, LLC. 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 Magnolia Lane Plastic Surgery, LLC was last updated on August 26, 2024. 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.