Independent US Healthcare Provider Directory & Public Medical Database Patient Guides

John Mark Lidell , MMSC, PA-C

Physician Assistant โ€ข Mcdonough, GA

Active NPI 1962487538 Individual Practitioner Male Practitioner Accepts Medicare assignment
Practice location in NPPES

101 Regency Park Dr Ste 110
Mcdonough, GA 302537076

Call 4049960126 Location details and other listings
Medical Disclaimer

This profile restates public CMS/NPPES data; T-MedInfo gives no medical advice — consult a licensed professional, and call 911 for emergencies.

Practice Location & Contact Primary Location

Practice Address

101 Regency Park Dr Ste 110

Mcdonough, GA 302537076

Telephone 4049960126
Fax 6784322626
Organization at the Same NPPES Address or Phone
Wellstreet Of Georgia Pc Facility NPI 1164910253

Matched by practice address or phone in NPPES. A shared address or phone does not confirm that this clinician works there.

Other Listings in Public Data

NPPES lists 2 distinct additional practice-address records in Stockbridge, GA. See the list

Source: CMS NPPES NPI Registry, practice location records; release date unavailable.

CMS Doctors and Clinicians lists 1 group name: Wellstar Medical Group Llc. See the list

Source: CMS Doctors and Clinicians National Downloadable File, release date unavailable.

Listings do not confirm current availability, employment or a shared ownership network.

Medicare Profile & Education

Source: CMS Doctors and Clinicians National Downloadable File

Graduation Year

1996

Medicare patients

146 people with Original Medicare in 2024

Different Original Medicare patients in 2024; counts below 11 are hidden; this does not show availability or quality.

Source: CMS, Medicare Physician & Other Practitioners โ€“ by Provider, 2024.

Medicare-allowed amount

About $16,239 in 2024

The total amount Medicare approved for these services in 2024. It includes what Medicare paid and what patients or their other insurance owed, such as the deductible and coinsurance.

What this does not show: Medicare-allowed amount

This is not the clinician's income. Part of it can go to a clinic or group practice, staff, equipment or drugs. It is not the price you will pay.

Source: CMS, Medicare Physician & Other Practitioners โ€“ by Provider and Service, 2024.

Paid by Medicare

About $12,339 in 2024

The part of the Medicare-allowed amount that Medicare itself paid in 2024, after patients' deductibles and coinsurance.

What this does not show: Paid by Medicare

This is not the clinician's income and not a measure of quality.

Source: CMS, Medicare Physician & Other Practitioners โ€“ by Provider and Service, 2024.

30-day fills

447 standardized 30-day fills in 2024

CMS converts prescriptions to 30-day supplies so they can be compared. A 90-day prescription counts as about three 30-day fills.

What this does not show: 30-day fills

It is not a count of patients and not a measure of quality.

Part D drug cost

$4,876 in 2024

The total cost of these prescriptions in 2024, paid by Medicare drug plans, patients and other payers together.

What this does not show: Part D drug cost

A higher cost often reflects the type of medicines a specialty uses. It is not your out-of-pocket cost and not a measure of quality.

Source: CMS, Medicare Part D Prescribers โ€“ by Provider and Drug, 2024.

Industry payments (Open Payments)

Fewer than 11 payment records totaling $124.27 in 2023

Drug and medical device companies must report certain payments to doctors and some other clinicians to CMS, such as meals, travel, speaking fees or research funding.

These records are submitted by drug and medical device companies, and a reported payment does not necessarily mean the financial relationship is improper.

General: payments not tied to research, such as meals, travel, consulting or speaking fees.

A reported payment does not necessarily mean the financial relationship is improper. Research payments can go to a hospital or university for a study the clinician leads, not to the clinician personally. Clinicians can dispute records with the company that reported them.

Source: CMS Open Payments, program year 2023.

Guide: How to read an Open Payments record

Years since graduation

30 years (graduated 1996)

CMS Doctors and Clinicians data list 1996 as the year this clinician finished professional school.

What this does not show: Years since graduation

It is not the number of years in practice, and more years does not mean better care.

Source: CMS Doctors and Clinicians National Downloadable File.

NPI first issued

2005

The year this clinician's National Provider Identifier (NPI) was issued. An NPI is a unique 10-digit ID that US health care providers use for billing.

What this does not show: NPI first issued

NPIs have been issued only since 2005, so this year is not necessarily when the clinician started practicing.

Source: CMS NPPES NPI Registry.

Accepts Medicare assignment

CMS data list this clinician as accepting Medicare assignment. This means agreeing to take the Medicare-approved amount as full payment for covered services.

Medicare assignment applies to Original Medicare. It does not tell you whether the clinician is in a Medicare Advantage plan's network, accepts other insurance, or is taking new patients.

Source: CMS Doctors and Clinicians; Medicare.gov, โ€œDoes your provider accept Medicare as full payment?โ€

Guide: What Medicare assignment means

No telehealth indicator

CMS shows this indicator only when recent Medicare claims include telehealth services. The clinician may still offer telehealth; ask the office.

Source: CMS, Telehealth Indicator on Medicare Care Compare (fact sheet, January 2023); CMS Doctors and Clinicians.

Guide: How Medicare covers telehealth

Enrolled in Medicare (PECOS)

John Lidell has a Medicare enrollment record in PECOS, the CMS system clinicians use to enroll so they can bill Medicare or order services for people with Medicare.

It does not show whether the clinician accepts assignment, is in your plan's network, or is taking new patients.

Source: CMS Medicare Fee-For-Service Public Provider Enrollment (PECOS); CMS Order and Referring file.

Guide: What Medicare enrollment (PECOS) means

Can order Medicare-covered services

CMS lists John Lidell as eligible to order or refer Medicare Part B clinical laboratory and imaging services, durable medical equipment (DME) and home health services for people with Medicare.

What this does not show: Can order Medicare-covered services

It does not mean the clinician offers these services directly.

Source: CMS Medicare Fee-For-Service Public Provider Enrollment (PECOS); CMS Order and Referring file.

Guide: What ordering and referring status means

Compared with the same specialty in Mcdonough and Georgia

Billing and prescribing volume is not a quality rating.

Medicare Part B services

Close to the middle for clinicians listed under Physician Assistant in Georgia (2024, 2,111 clinicians with data). Median for this group: 206. Middle half: 69 to 679.

Too few clinicians listed under Physician Assistant in Mcdonough have Medicare Part B data for 2024 to compare.

Medicare-allowed amount

Close to the middle for clinicians listed under Physician Assistant in Georgia (2024, 2,111 clinicians with data). Median for this group: $15,567. Middle half: $5,959 to $34,890.

Too few clinicians listed under Physician Assistant in Mcdonough have Medicare Part B data for 2024 to compare.

Paid by Medicare

Close to the middle for clinicians listed under Physician Assistant in Georgia (2024, 2,111 clinicians with data). Median for this group: $11,516. Middle half: $4,485 to $25,995.

Too few clinicians listed under Physician Assistant in Mcdonough have Medicare Part B data for 2024 to compare.

Medicare Part D prescriptions

More Part D prescriptions than 60% of clinicians listed under Physician Assistant in Mcdonough, GA (2024, 11 clinicians with data). Median for this group: 412. Middle half: 170 to 674.

More Part D prescriptions than 65% of clinicians listed under Physician Assistant in Georgia (2024, 2,084 clinicians with data). Median for this group: 227. Middle half: 71 to 699.

Part D drug cost

A lower Part D drug cost than 70% of clinicians listed under Physician Assistant in Mcdonough, GA (2024, 11 clinicians with data). Median for this group: $14,042. Middle half: $2,969 to $30,522.

Close to the middle for clinicians listed under Physician Assistant in Georgia (2024, 2,084 clinicians with data). Median for this group: $4,172. Middle half: $609 to $75,033.

21 active clinicians are listed under Physician Assistant with a practice address in Mcdonough, GA (4,665 in Georgia).

Addresses are self-reported to NPPES and may be out of date.

Telehealth indicator in Mcdonough

4.8% of these 21 clinicians have the CMS telehealth indicator.

42.9% of these 21 clinicians are listed by CMS as accepting Medicare assignment.

Sources: CMS Medicare Physician & Other Practitioners (2024), CMS Medicare Part D Prescribers (2024), CMS Open Payments (2023), CMS Doctors and Clinicians, CMS NPPES NPI Registry. Specialty names follow the NUCC Health Care Provider Taxonomy.

Text: T-MedInfo ยท Report an error.

Pharma & Medical Device Financial Disclosures

Payments and other transfers of value that drug and medical device companies reported to CMS Open Payments

Open Payments ยท Program Year 2023

Program year 2023 (payments made January 1 โ€“ December 31, 2023): fewer than 11 records totaling $124.27.

Manufacturer Payment Nature Product Type Amount ($)
Horizon Therapeutics plc
Food and Beverage
In-kind items and services
KRYSTEXXA General $124.27

Source: CMS Open Payments, program year 2023, released June 30, 2026.

Performed Procedures & Service Volume

Services billed to Original Medicare Part B in 2024.

CMS Part B ยท Data Year 2024
Reporting Year:

CPTยฎ is a registered trademark of the American Medical Association. CPT codes, descriptions and other data only are copyright 2016โ€“2023 American Medical Association. All rights reserved. Applicable FARS/HHSARS apply. Descriptions of CPT codes are the AMA's CPT Consumer Friendly Descriptors as published by CMS in the Medicare Physician & Other Practitioners โ€“ by Provider and Service data, 2017โ€“2024; they are plain-language summaries, not for clinical coding or documentation. HCPCS Level II codes and descriptions are from CMS. Fee schedules, relative value units, conversion factors and/or related components are not assigned by the AMA, are not part of CPT, and the AMA is not recommending their use. The AMA does not directly or indirectly practice medicine or dispense medical services. The AMA assumes no liability for data contained or not contained herein.

HCPCS Code Services Patients Submitted Charge Medicare Allowed
99213 Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more
93 89 $208.43 $78.47
87428 Detection test by immunoassay technique for severe acute respiratory syndrome coronavirus and influenza
45 44 $135.16 $68.88
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more
29 29 $271.17 $95.97
96372 Injection of drug or substance under skin or into muscle
24 20 $72.00 $12.34
87880 Detection test by immunoassay with direct visual observation for streptococcus, group a (strep)
23 23 $62.09 $16.20
81003 Automated urinalysis test
21 21 $12.00 $2.20
71046 X-ray of chest, 2 views
14 14 $63.00 $23.58
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more
14 13 $129.00 $48.93
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more
12 11 $297.00 $110.70

Source: CMS Part B by Provider and Service, 2024; services under 11 beneficiaries omitted by CMS. Privacy limits

Submitted charges are billed amounts, not a price quote for your visit.

Medicare Part D Prescribing Profile & Medications

Medicare Part D prescriptions filled, including refills, in 2024.

CMS Part D ยท Data Year 2024
Prescription Year:
Brand Name Generic Name Prescriptions Day Supply Total Cost Patients
Fluticasone Propionate Fluticasone Propionate 84 2,460 $774.91 73
Albuterol Sulfate Hfa Albuterol Sulfate 60 1,352 $1,422.37 47
Azithromycin Azithromycin 45 225 $164.51 44
Cefuroxime Cefuroxime Axetil 38 351 $608.96 38
Clindamycin Hcl Clindamycin Hcl 29 274 $331.64 28
Mupirocin Mupirocin 28 540 $163.32 24
Nitrofurantoin Mono-Macro Nitrofurantoin Monohyd/M-Cryst 26 183 $286.07 23
Paxlovid Nirmatrelvir/Ritonavir 24 125 $0.00 24
Ofloxacin Ofloxacin 18 154 $353.46 18
Methylprednisolone Methylprednisolone 16 96 $91.49 16
Cefdinir Cefdinir 15 143 $161.15 15
Doxycycline Hyclate Doxycycline Hyclate 14 134 $180.02 14
Prednisone Prednisone 13 80 $57.18 12
Acetaminophen-Codeine Acetaminophen With Codeine 12 37 $30.22 12
Ketoconazole Ketoconazole 11 230 $197.71 โ€”
Diclofenac Potassium Diclofenac Potassium 11 80 $52.53 11

Source: CMS Part D by Provider and Drug, 2024; rows below 11 claims omitted by CMS; volume isn’t quality. Privacy limits

Specialties & License Numbers Reported to NPPES

Self-certified to NPPES: 2021-10-27
Physician Assistant Primary Specialty

NUCC Taxonomy Code: 363A00000X

License # reported to NPPES GA 002952

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

Check License Status with the State Board License numbers are self-reported to NPPES; T-MedInfo does not confirm them against state records. Current status: Georgia Composite Medical Board.
Look Up on State Board Site

Medicare (PECOS) Enrollment & Ordering Eligibility

Source: CMS PECOS
Medicare FFS Enrollment Status Medicare Enrollment on File
CMS Provider Specialty

PRACTITIONER - PHYSICIAN ASSISTANT

Medicare Enrollment ID

I20080619000285

Enrollment State Jurisdiction

GA

PECOS Control ID

4688745615

Medicare Order & Referring Eligibility
Clinical Lab & Imaging (Part B) Eligible
Durable Medical Equipment (DME) Eligible
Home Health Agency (HHA) Eligible
Power Mobility Devices (PMD) Eligible

Sources: CMS Provider Enrollment and Order and Referring. Medicare enrollment is a billing status, not an accreditation or quality rating.

Medicare Group Practice Enrollments

Source: CMS Doctors and Clinicians National Downloadable File

Wellstar Medical Group Llc

4480 N Cooper Lake Serd, Smyrna, GA 300824623

Wellstar Medical Group Llc

1025 E W Connector, Austell, GA 301068532

Phone: 6782733071

Wellstar Medical Group Llc

4480 N Cooper Lake Rd Se, Smyrna, GA 300824623

Wellstar Medical Group Llc

780 Church St Ne, Marietta, GA 300607269

Wellstar Medical Group Llc

12460 Crabapple Rd, Alpharetta, GA 300046392

Phone: 6787620574

Wellstar Medical Group Llc

5150 Stilesboro N W Rd, Kennesaw, GA 301527742

Phone: 7704248222

Wellstar Medical Group Llc

4477 Towne Lake Pkwy, Woodstock, GA 301896720

Phone: 7702495620

Secondary Practice Locations

913 Eagles Landing Pkwy Ste 150

Stockbridge, GA 302815011

Phone: 7706925910

3576 Highway 138 Se

Stockbridge, GA 302817909

Phone: 7704747448

Clinicians Sharing This Practice Address or Phone

Clinicians sharing this NPPES address, phone or fax; a shared contact does not mean they work together.

4 listed
Shuvory Green , FNP-C

Nurse Practitioner - Family

NPI 1487994901

Family Nurse Practitioner (Certified)

NPI 1639693419

MMS, Physician Assistant (Certified)

Dr. Ishani Patel , MD

Family Medicine

NPI 1245812569

Doctor of Medicine (M.D.)

Daphene Smith , PA

Physician Assistant

NPI 1497869689

Physician Assistant

Career & Practice History Timeline

Changes recorded in monthly NPPES data files: addresses, names, credentials, specialties and NPI status

21 Historical Events
๐Ÿ“
Updated Business Mailing Address October 27, 2021

Registered at 3576 HIGHWAY 138 SE, STOCKBRIDGE, GA 302817909 (Tel: 7704747448)

โœ…
NPI Profile Active March 17, 2018

NPI status registered as active in NPPES database

๐Ÿ“
Updated Practice Location March 17, 2018

Registered at 101 REGENCY PARK DR STE 110, MCDONOUGH, GA 302537076 (Tel: 4049960126)

๐Ÿ“
Updated Business Mailing Address March 17, 2018

Registered at 101 YORKTOWN DR, SUITE 110, FAYETTEVILLE, GA 302141578 (Tel: 6783645400)

๐Ÿ‘ค
Provider Name / Credentials Updated March 17, 2018

Recorded as JOHN LIDELL, M.M.SC. , PA-C

๐ŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) March 17, 2018

Physician Assistant (license number reported to NPPES: GA 002952)

โœ…
NPI Profile Active October 11, 2017

NPI status registered as active in NPPES database

๐Ÿ“
Updated Practice Location October 11, 2017

Registered at 101 REGENCY PARK DR STE 110, MCDONOUGH, GA 302537076 (Tel: 4049960126)

๐Ÿ“
Updated Business Mailing Address October 11, 2017

Registered at 101 YORKTOWN DR, SUITE 110, FAYETTEVILLE, GA 302141578 (Tel: 6783645400)

๐Ÿ‘ค
Provider Name / Credentials Updated October 11, 2017

Recorded as JOHN LIDELL, M.M.SC. , PA-C

๐ŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) October 11, 2017

Physician Assistant (license number reported to NPPES: GA 002952)

๐Ÿ“
Updated Practice Location April 17, 2017

Registered at 101 YORKTOWN DR, SUITE 110, FAYETTEVILLE, GA 302141578 (Tel: 6783645400)

๐Ÿ“
Updated Business Mailing Address April 17, 2017

Registered at 101 YORKTOWN DR, SUITE 110, FAYETTEVILLE, GA 302141578 (Tel: 6783645400)

๐ŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) April 17, 2017

Physician Assistant (license number reported to NPPES: GA 002952)

๐Ÿ“
Updated Practice Location January 30, 2017

Registered at 4861 BILL GARDNER PKWY, LOCUST GROVE, GA 302483644 (Tel: 7706265740)

โœ…
NPI Profile Active July 18, 2014

NPI status registered as active in NPPES database

๐Ÿ“
Practice Location (Initial Record) July 18, 2014

Registered at 1418 SCOTT BLVD, DECATUR, GA 300301424 (Tel: 7706265760)

๐Ÿ“
Business Mailing Address (Initial Record) July 18, 2014

Registered at 5429 LBJ FWY, DALLAS, TX 752402607 (Tel: 7706265760)

๐Ÿ‘ค
Provider Name / Credentials (Initial Record) July 18, 2014

Recorded as JOHN LIDELL, M.M.SC. , PA-C

๐ŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) July 18, 2014

Physician Assistant (license number reported to NPPES: GA 002952)

๐ŸŸข
Initial NPI Registration & Enumeration December 07, 2005

First registered as active Individual Practitioner in NPPES Database.

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NPI Administrative Meta

NPI Number: 1962487538
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: December 07, 2005
Last Update: October 27, 2021
Sole Proprietor: No

Other Physician Assistants in Mcdonough

All Physician Assistants in Mcdonough

Mailing Address

3576 Highway 138 Se

Stockbridge, GA 302817909

Phone: 7704747448

About This Data NPPES fields (address, phone, specialty, license) are self-reported and may be outdated; Medicare fields follow the CMS dataset named in each section. Correct directly at NPPES.