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JACK HANSON ANZILOTTI PAC
NPI 1730711151
Physician Assistant - Surgical in Atlanta, GA

Active since February 05, 2020PECOS EnrolledAccepts Medicare Assignment
980 JOHNSON FERRY RD STE 800, ATLANTA, GA 30342(404) 252-9063(404) 252-0873 Get Directions Write a Review

NPPES record last updated: July 30, 2025. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Mar 30, 2020, Feb 5, 2020 (2 updates tracked since 2020).

About Jack Hanson Anzilotti Pac NPPES

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

JACK HANSON ANZILOTTI PAC (NPI 1730711151) is an individual surgical provider in Atlanta, Georgia, licensed in Georgia (12988) and active in the NPI registry since February 2020. He is enrolled in Medicare PECOS, is affiliated with Northside Hospital Forsyth, and maintains a secondary practice location in Orlando.

NPPES Registry Identity

NPI1730711151
Entity TypeIndividualMale
Primary Taxonomy363AS0400X
Provider Legal NameJACK HANSON ANZILOTTICredential: PAC
Location Address980 JOHNSON FERRY RD STE 800Atlanta, GA 30342-1608
Mailing Address980 Johnson Ferry RdAtlanta, GA 30342-1626 · (703) 389-1425
Phone(404) 252-9063
Fax(404) 252-0873
Sole ProprietorNo
Medical School CMSOtherGraduated 2019
Enumeration DateFebruary 5, 2020
Last NPPES UpdateJuly 30, 20252 updates tracked since enumeration
NPPES CertifiedJuly 30, 2025
✔ NPI 1730711151 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician Assistant · SurgicalPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363AS0400X
Licenses✔ Licensed in GA · 12988✔ Licensed in FL · PA9113011
980 JOHNSON FERRY RD STE 800, Atlanta, GA 30342
Open in Google Maps ↗

Secondary Practice Location 1

Location 189 W Copeland DrOrlando, FL 32806-2002 · Phone (321) 841-7550 · Fax (321) 841-8185

Other Identifiers 1

Medicaid105528800FL

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include AmeriHealth Caritas Next, AvMed, Molina Healthcare.Insurance ›

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

Jack Hanson Anzilotti Pac 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 ID2062849300
PECOS Enrollment IDI20200225002743, I20250820000560
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.

Areas of Expertise CMS Part B claims

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232
Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.
33 services27 patients

Hospital Affiliations CMS Care Compare 2

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Northside Hospital Forsyth

Acute Care Hospitals · Cumming, GA
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number110005
Location1200 Northside Forsyth DriveCumming, GA 30041 · Forsyth County
Birthing friendly

Northside Hospital

Acute Care Hospitals · Atlanta, GA
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number110161
Location1000 Johnson Ferry Road, NEAtlanta, GA 30342 · Fulton County
Birthing friendly

Other Providers at the Same Location NPPES

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

MICHAL HUBKA MD
Thoracic Surgery (Cardiothoracic Vascular Surgery)
980 JOHNSON FERRY RD STE 800
ATLANTA, GA 30342
Fulton County (404) 252-9063

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 Jack Anzilotti's NPI number?

The NPI number for Jack Anzilotti is 1730711151. It was assigned to this individual provider in the NPPES registry on February 5, 2020.

Where is Jack Anzilotti located?

Jack Anzilotti practices at 980 Johnson Ferry Rd Ste 800, Atlanta, GA 30342. The listed phone number is (404) 252-9063.

What is Jack Anzilotti's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Surgical, with taxonomy code 363AS0400X.

Is Jack Anzilotti enrolled in Medicare?

Yes. Jack Anzilotti is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Jack Anzilotti accept?

Health plans from AmeriHealth Caritas Next, AvMed and Molina Healthcare list Jack Anzilotti 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.

Is Jack Anzilotti affiliated with any hospitals?

According to CMS data, Jack Anzilotti is affiliated with Northside Hospital Forsyth and Northside Hospital.

When was this NPI record last updated?

The NPPES record for Jack Anzilotti was last updated on July 30, 2025. NPI Profile syncs with the weekly NPPES data releases published by CMS.