Su Yung Anderson, PA
Individual provider Active NPI Anesthesiologist Assistant · Dunwoody, GA
NPI 1023063476 · NPPES record last updated Oct 17, 2016
Key facts
- NPI
- 1023063476
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Anesthesiologist Assistant 367H00000X
- License
- 002713 (GA)
- Practice address
- 1870 Independence SQ
Suite D
Dunwoody, GA 30338-5155 - Phone
- (770) 396-6190
- Fax
- (770) 396-5541
- NPI assigned
- May 24, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 4
Medicare Care Compare profile
- Specialty
- Anesthesiology Assistant
- Education
- Other, 1994
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Ambulatory Anesthesia Alliance of Ga LLC
Practice addresses (Care Compare)
1870 Independence SQ D
Atlanta, GA 30338-5155
Phone (404) 351-0500
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in GA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20040517001346 | GA | Practitioner - Anesthesiology Assistant | 6103816517 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Associate of Arts, Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 002713 | GA | MD | Anesthesiologist Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Fayette Community Anesthesia | Past | Accepting new patients | |
| Piedmont Anesthesia Associates, L.L.C | Past | Accepting new patients | |
| Northlake Anesthesia Professionals, LLC | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiologist Assistant | 367H00000X | 002713 | GA | Yes |
Addresses
Primary practice location
1870 Independence SQ
Suite D
Dunwoody, GA 30338-5155
Mailing address
660 Elmwood Dr NE
Atlanta, GA 30306-3644
Other providers in Dunwoody, GA
- Anchor Point Home Care LLC
- Anchored & Whole Wellness, LLC
- John G Anderson
- Jonielle Monet Anderson
- Shamika Anderson
- Steven Michael Andrews
- Anna Gray Therapy, LLC
- Anne-Marie Campbell, LLC
- Kenneth Anokye
- Amir Antonios
All providers in Dunwoody, GA · Anesthesiologist Assistant in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 17, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.