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

Mr. Charles Marcus Bass Jr., PA

Individual provider Physician Assistant · NPI 1306100979

Mr. Charles Marcus Bass Jr., PA is a Physician Assistant in Gainesville, Georgia. Graduated from Mercer University School of Medicine in 2012, 14 years ago. Practices with Northside Surgical Professional Services LLC, a 368-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Georgia.

Years since qualifying
14
Trained at
Mercer University School of Medicine
Licensed in
GA
In the registry since
2012
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

1485 Jesse Jewell Pkwy NE Ste 220A
Gainesville, GA 30501
Phone: (770) 740-1860
Fax: (678) 347-2104
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 2365 Old Milton Pkwy, Alpharetta, GA 30009-2140 — (770) 740-1860

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 006476 (GA)

Record details

NPI number1306100979
Entity typeIndividual (Type 1)
GenderMale
Credentials PA
Sole proprietorNo
NPI enumeratedJune 28, 2012
Last updated in NPPESSeptember 20, 2018

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolMERCER UNIVERSITY SCHOOL OF MEDICINE
Graduated 2012 (14 years in practice)
Group practice Northside Surgical Professional Services Llc — 368 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations4 on file with Medicare

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