MISS MERCEDES R TATUM PA
NPI 1891514162
Physician Assistant in Gainesville, GA

Active since October 04, 2024PECOS EnrolledAccepts Medicare Assignment
663 LANIER PARK DR, GAINESVILLE, GA 30501(678) 450-0202(678) 450-0080 Get Directions Write a Review

NPPES record last updated: January 28, 2025. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Miss Mercedes R Tatum Pa NPPES

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

MISS MERCEDES R TATUM PA (NPI 1891514162) is an individual physician assistant in Gainesville, Georgia, licensed in Georgia (12598) and active in the NPI registry since October 2024. She is enrolled in Medicare PECOS, is affiliated with Northside Hospital Forsyth, and is a graduate of Philadelphia College Of Osteopathic Medicine (2024).

NPPES Registry Identity

NPI1891514162
Entity TypeIndividualFemale
Primary Taxonomy363A00000X
Provider Legal NameMISS MERCEDES R TATUMCredential: PA
Location Address663 LANIER PARK DRGainesville, GA 30501-2059
Mailing Address663 Lanier Park DrGainesville, GA 30501-2059 · (678) 450-0202 · Fax (678) 450-0080
Fax(678) 450-0080
Sole ProprietorNo
Medical School CMSPhiladelphia College Of Osteopathic MedicineGraduated 2024
Enumeration DateOctober 4, 2024
Last NPPES UpdateJanuary 28, 2025
NPPES CertifiedJanuary 17, 2025
NPI 1891514162 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
License Licensed in GA · 12598
Definition

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

663 LANIER PARK DR, Gainesville, GA 30501

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

Miss Mercedes R Tatum 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 ID1052844412
PECOS Enrollment IDI20241024001270
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.

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

Northeast Georgia Medical Center, Inc

Acute Care Hospitals · Gainesville, GA
3/5 CMS rating
OwnershipGovernment - Local
CMS Certification Number110029
Location743 Spring StreetGainesville, GA 30501 · Hall County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 30501 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$83.23 typical visit price
range $53.31 – $164.04
Typical copayment $20.80 (range $13.32 – $41.01)
Most-billed visit code 99203
Established Patient
$66.89 typical visit price
range $16.68 – $133.24
Typical copayment $16.72 (range $4.17 – $33.31)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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.

Internal Medicine (Nephrology)
663 LANIER PARK DR
GAINESVILLE, GA 30501
Internal Medicine (Nephrology)
663 LANIER PARK DR
GAINESVILLE, GA 30501
Internal Medicine (Nephrology)
663 LANIER PARK DR
GAINESVILLE, GA 30501
Physician Assistant (Medical)
663 LANIER PARK DR
GAINESVILLE, GA 30501
Internal Medicine (Nephrology)
663 LANIER PARK DR
GAINESVILLE, GA 30501
Specialist
663 LANIER PARK DR
GAINESVILLE, GA 30501
Physician Assistant (Medical)
663 LANIER PARK DR
GAINESVILLE, GA 30501
Nurse Practitioner (Adult Health)
663 LANIER PARK DR
GAINESVILLE, GA 30501

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 Mercedes Tatum's NPI number?

The NPI number for Mercedes Tatum is 1891514162. It was assigned to this individual provider in the NPPES registry on October 4, 2024.

Where is Mercedes Tatum located?

Mercedes Tatum practices at 663 Lanier Park Dr, Gainesville, GA 30501. The listed phone number is (678) 450-0202.

What is Mercedes Tatum's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Is Mercedes Tatum enrolled in Medicare?

Yes. Mercedes Tatum 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.

Is Mercedes Tatum affiliated with any hospitals?

According to CMS data, Mercedes Tatum is affiliated with Northside Hospital Forsyth and Northeast Georgia Medical Center, Inc.

When was this NPI record last updated?

The NPPES record for Mercedes Tatum was last updated on January 28, 2025. NPI Profile syncs with the weekly NPPES data releases published by CMS.