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DMITRI KODOR PA-C
NPI 1679883748
Physician Assistant - Medical in Norcross, GA

Active since October 07, 2010PECOS Enrolled
6330 PRIMROSE HILL CT, NORCROSS, GA 30092(770) 343-8760(770) 664-2101 Get Directions Write a Review

NPPES record last updated: June 24, 2014. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Dmitri Kodor Pa-c NPPES

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

DMITRI KODOR PA-C (NPI 1679883748) is an individual medical provider in Norcross, Georgia, licensed in Georgia (02933) and active in the NPI registry since October 2010. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1679883748
Entity TypeIndividualMale
Primary Taxonomy363AM0700X
Provider Legal NameDMITRI KODORCredential: PA-C
Location Address6330 PRIMROSE HILL CTNorcross, GA 30092
Mailing AddressPo Box 769609Roswell, GA 30076-8224 · (770) 343-8760 · Fax (770) 664-2101
Phone(770) 343-8760
Fax(770) 664-2101
Sole ProprietorNo
Enumeration DateOctober 7, 2010
Last NPPES UpdateJune 24, 2014
✔ NPI 1679883748 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician Assistant · MedicalPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363AM0700X
License✔ Licensed in GA · 02933
6330 PRIMROSE HILL CT, Norcross, GA 30092
Open in Google Maps ↗

Other Identifiers 2

Medicaid003142752AGA
Medicare PIN20297I5350GA

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dmitri Kodor Pa-c 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.

Other Providers at the Same Location NPPES 14

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

TINA V WILLIAMS M.D.
Family Medicine
6330 PRIMROSE HILL CT
NORCROSS, GA 30092
Gwinnett County (770) 903-0134
BARNABAS YOO
Physical Therapist (Electrophysiology, Clinical)
6330 PRIMROSE HILL CT
NORCROSS, GA 30092
Gwinnett County (470) 809-1581
DR. ADEMOLA ADEBAYO OPANUGA M.D.
Family Medicine
6330 PRIMROSE HILL CT
NORCROSS, GA 30092
Gwinnett County (404) 365-0160
OZLEM PALA MD
Internal Medicine (Rheumatology)
6330 PRIMROSE HILL CT
PEACHTREE CORNERS, GA 30092
Gwinnett County (770) 903-0144
DR. VLADISLAV ISKHAKOV PT, DPT
Physical Therapist
6330 PRIMROSE HILL CT
NORCROSS, GA 30092
Gwinnett County (770) 309-8108
LESLIE K HARDISON RN
Registered Nurse
6330 PRIMROSE HILL CT, SUITE 207
NORCROSS, GA 30092
Gwinnett County (770) 452-0017
NARESH K PARIKH M.D.
Internal Medicine (Cardiovascular Disease)
6330 PRIMROSE HILL CT
NORCROSS, GA 30092
Gwinnett County (770) 903-0144
DR. ALENA GORDON D.P.M.
Podiatrist
6330 PRIMROSE HILL CT
NORCROSS, GA 30092
Gwinnett County (404) 365-0160

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 Dmitri Kodor's NPI number?

The NPI number for Dmitri Kodor is 1679883748. It was assigned to this individual provider in the NPPES registry on October 7, 2010.

Where is Dmitri Kodor located?

Dmitri Kodor practices at 6330 Primrose Hill Ct, Norcross, GA 30092. The listed phone number is (770) 343-8760.

What is Dmitri Kodor's specialty?

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

Is Dmitri Kodor enrolled in Medicare?

Yes. Dmitri Kodor is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Dmitri Kodor was last updated on June 24, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 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.