Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Mattea Krasicky, PA

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1407593668

Mattea Krasicky, PA is a Physician Assistant in Marietta, Georgia. Qualified in 2022, 4 years ago. Practices with Wellstar Medical Group LLC, a 3,072-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Georgia.

Years since qualifying
4
Licensed in
GA
In the registry since
2022
Specialties on file
2
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

See every abbreviation used in this directory →

Practice location Address checks out

400 Tower Rd NE Ste 200
Marietta, GA 30060-9412
Phone: (770) 422-1372
Fax: (770) 999-2488
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 625 Old Peachtree Rd Nw, Suwanee, GA 30024-2937 — (678) 225-7500

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 11244 (GA)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1407593668
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA
Sole proprietorYes
NPI enumeratedMay 18, 2022
Last updated in NPPESFebruary 20, 2023
Certification dateFebruary 20, 2023
Mailing address400 Tower Rd Ne Ste 200, Marietta, GA 30060-9412

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2022 (4 years in practice)
Group practice Wellstar Medical Group Llc — 3072 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations5 on file with Medicare

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