MR. DAVID WILLIAM CONN PA-C
NPI 1164099958
Physician Assistant - Surgical in Lawrenceville, GA

NPI Status: Active since June 09, 2021

Contact Information

601 PROFESSIONAL DR STE 220
LAWRENCEVILLE, GA
ZIP 30046
Phone: (912) 695-0342

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  • Individual
  • Male
  • Years of Experience 5
  • Physician Assistant
  • Surgical
  • Accepts Medicare Approved Payment
  • PECOS Enrolled

About DAVID CONN

This page provides the complete NPI Profile along with additional information for David Conn, a provider established in Lawrenceville, Georgia with a medical specialization in Physician Assistant, focusing in surgical and more than 5 years of experience. The healthcare provider is registered in the NPI registry with number 1164099958 assigned on June 2021. The practitioner's primary taxonomy code is 363AS0400X with license number 10388 (GA). The provider is registered as an individual and his NPI record was last updated 3 years ago.

NPI
1164099958
Provider Name
MR. DAVID WILLIAM CONN PA-C
Gender
Male
Entity Type
Individual
Location Address
601 PROFESSIONAL DR STE 220 LAWRENCEVILLE, GA 30046
Location Phone
(912) 695-0342
Mailing Address
601 PROFESSIONAL DR STE 220 LAWRENCEVILLE, GA 30046
Mailing Phone
(912) 695-0342
Medical School Name
OTHER
Graduation Year
2021
Is Sole Proprietor?
Yes
Enumeration Date
06-09-2021
Last Update Date
03-16-2022
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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Physician Assistant Surgical

Taxonomy Code
363AS0400X
Type
Physician Assistants & Advanced Practice Nursing Providers
License No.
10388
License State
GA

Medicare Participation & PECOS Enrollment Status

David Conn is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.

David Conn is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.

  • Is the provider registered in PECOS? Yes

  • PECOS PAC ID: 3678971215

    What is the PECOS Associate Control ID?
    A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.

  • PECOS Enrollment ID: I20211012001084

    What is the Provider Enrollment ID?
    The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.

  • Accepts Medicare Assignment? Yes

    What does it mean "accepts medicare assignment"?
    When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
    A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.

  • Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes

  • Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes

  • Eligible to Order or Refer a Home Health Agency (HHA): Yes

  • Eligible to Order or Refer Power Mobility Devices: Yes

Areas of Expertise

The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.

Established patient office or other outpatient visit, 20-29 minutes

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

This service was performed 101 times for 80 patients

Established patient office or other outpatient visit, 30-39 minutes

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

This service was performed 23 times for 19 patients

New patient office or other outpatient visit, 30-44 minutes

This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.

This service was performed 39 times for 39 patients

Find Provider Hospital Affiliations - Privileges

Doctors and physicians must apply for hospital privileges to treat patients at hospitals. Find out if your doctor has privileges to practice at your preferred hospital by using the hospital affiliation information below based on recent medical claims.

Hospital affiliation is identified through self-reporting data, inpatient, outpatient, physician and ancillary service claims linked by the medical claims NPI number and place of service code. Additionally, to further determine provider hospital affiliation the clinician must have provided services to at least three patients on three different dates in the last 12 months. David Conn is affiliated with the following medical facilities:

Hospital Name Address Phone Hospital Type Overall Rating
NORTHSIDE HOSPITAL GWINNETT1000 MEDICAL CENTER BOULEVARD
LAWRENCEVILLE, GA 30046
(678) 312-1000Acute Care Hospitals

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NPI Validation Check Digit Calculation


The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.

Start with the original NPI number, the last digit is the check digit and is not used in the calculation.
1164099958
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
211240918910
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 1 + 1 + 2 + 4 + 0 + 9 + 1 + 8 + 9 + 1 + 0 + 24 = 62
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
70 - 62 = 88

The NPI number 1164099958 is valid because the calculated check digit 8 using the Luhn validation algorithm matches the last digit of the original NPI number.

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1164099958, enumerated in the NPI registry as an "individual" on June 09, 2021

The provider is located at 601 Professional Dr Ste 220 Lawrenceville, Ga 30046 and the phone number is (912) 695-0342

The provider's speciality is Physician Assistant with taxonomy code 363AS0400X with a focus in Surgical

The provider has more than 5 years of experience.

Yes, as of June 20, 2025 the provider is registered in PECOS and is eligible to order health care services or supplies for Medicare patients. If you are a beneficiary the provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

The most common procedures or services performed by this practitioner are: Established patient office or other outpatient visit, 20-29 minutes, Established patient office or other outpatient visit, 30-39 minutes and New patient office or other outpatient visit, 30-44 minutes.

The practitioner is affiliated to the following hospital(s): NORTHSIDE HOSPITAL GWINNETT. Hospital affiliations are identified through self-reporting data and service claims based on the place of service.

This NPI record was last updated on June 09, 2021. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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