Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.
NPIDirectory

Jack Hanson Anzilotti, PAC

Individual provider Surgical Physician Assistant · NPI 1730711151

Jack Hanson Anzilotti, PAC is a Physician Assistant in Atlanta, Georgia. Qualified in 2019, 7 years ago. Practices with Northside Surgical Professional Services LLC, a 368-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Florida and Georgia.

Years since qualifying
7
Licensed in
FL, GA
In the registry since
2020
Specialties on file
2
What do these letters mean?
PAC — Physician Assistant, Certified
A physician assistant holding current national certification; usually written PA-C.

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Practice location Address checks out

980 Johnson Ferry Rd Ste 800
Atlanta, GA 30342-1608
Phone: (404) 252-9063
Fax: (404) 252-0873
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 89 W Copeland Dr, Orlando, FL 32806-2002 — (321) 841-7550

Specialties & licences

Surgical Physician Assistant (primary) Taxonomy 363AS0400X · Licence 12988 (GA)
Surgical Physician Assistant Taxonomy 363AS0400X · Licence PA9113011 (FL)

Record details

NPI number1730711151
Entity typeIndividual (Type 1)
GenderMale
Credentials PAC
Sole proprietorNo
NPI enumeratedFebruary 5, 2020
Last updated in NPPESJuly 30, 2025
Certification dateJuly 30, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2019 (7 years in practice)
Group practice Northside Surgical Professional Services Llc — 368 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations8 on file with Medicare

Medicare patients and services, 2024

From the CMS Medicare Physician & Other Practitioners file for calendar year 2024. It counts Original Medicare patients only, so a practice that mostly sees Medicare Advantage or privately insured patients looks smaller here than it is.

Medicare patients51
Services billed 62 a service is one billed item, such as a visit, a test or a procedure
Average patient age76

Dollar amounts are not shown. What Medicare pays a practice is gross billings, before staff, premises and tax and including the cost of any drugs it administers, so it is not what a clinician earns.

Payments from drug and device companies, 2025

Drug and device makers are required by federal law (the Physician Payments Sunshine Act) to report what they pay or give to clinicians, and CMS publishes the reports as Open Payments. This is the 2025 program year. A report is a record of a payment, not an allegation of anything, and many are small items such as meals. Only general payments are listed here; research payments and ownership or investment interests are reported separately by CMS and are not shown.

Food and Beverage $70 2 payments · a meal or drink at a meeting or visit, not a fee

Each amount is the sum of what companies reported for that kind of payment in 2025, rounded to the dollar. Not all of it is income to the clinician: a meal is not a fee, a charitable contribution goes to a charity, and a royalty or an acquisition payment is not a salary.

Check a report, or dispute one, at the source in CMS’s own tool, Open Payments. Corrections go through CMS’s dispute process. This site removes a home address on request and asks for no proof, because that is privacy; it will not remove an accurate payment report on request, because that is a statutory public disclosure.

Practises at

Facilities the CMS Facility Affiliation file lists for this clinician.

Colleagues at Northside Surgical Professional Services LLC

Clinicians the CMS Doctors & Clinicians file lists under the same group practice. CMS counts 368 clinicians in the practice; 12 are shown here.

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