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

Mikaela M Peribonio, AGNP-C

Individual provider Registered Nurse · NPI 1811610553

Mikaela M Peribonio, AGNP-C is a Nurse Practitioner in Marietta, Georgia. Graduated from University of Alabama School of Medicine in 2024, 2 years ago. Practices with Physiotherapy Associates Inc, a 1,458-clinician group and accepts Medicare assignment. Licensed in Georgia.

Years since qualifying
2
Trained at
University of Alabama School of Medicine
Licensed in
GA
In the registry since
2022
Specialties on file
2
Claim this listing Report a problem Suggest an edit

Practice location Address checks out

790 Church St NE Ste 300
Marietta, GA 30060-8940
Phone: (770) 422-3290
Fax: (770) 422-0287
Show map & directions

Directions in Google Maps · Apple Maps · OpenStreetMap

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

Specialties & licences

Gerontology Nurse Practitioner (primary) Taxonomy 363LG0600X · Licence NP291729 (GA)
Registered Nurse Taxonomy 163W00000X · Licence RN291729 (GA)

Record details

NPI number1811610553
Entity typeIndividual (Type 1)
GenderFemale
Credentials AGNP-C
Sole proprietorNo
NPI enumeratedSeptember 19, 2022
Last updated in NPPESNovember 20, 2025
Certification dateNovember 20, 2025

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolUNIVERSITY OF ALABAMA SCHOOL OF MEDICINE
Graduated 2024 (2 years in practice)
Group practice Physiotherapy Associates Inc — 1458 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

Other providers in Marietta