Individual provider Active NPI

Wossen Adinew Asfaw

  • Physician Assistant
  • Duluth, GA
National Provider Identifier
1033667266
Registry record updated Sep 16, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
1133058 Issued in GA
Practice address
3575 Koger Blvd Ste 116
Duluth, GA 30096-7559
Phone
(770) 923-4433
NPI assigned
Sep 16, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 16, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 1133058 GA Primary

Addresses

Primary practice location

3575 Koger Blvd Ste 116
Duluth, GA 30096-7559

Mailing address

3575 Kroger Blvd Suite 116
Duluth, GA 30096-9004
Phone (770) 923-4433

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171107001977 GA Practitioner - Physician Assistant 7214211952 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
93.24 of 100Reported as group
Quality
73.72
Promoting interoperability
100
Improvement activities
40
Cost
75.22

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
8214GAMDDentist
1133058GAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Emory Medical Care Foundation Inc CurrentSince Feb 21, 2020 Accepting new patients
The Emory Clinic Inc CurrentSince Feb 21, 2020 Accepting new patients
North Atlanta Oncology Services LLC CurrentSince Feb 8, 2026 Accepting new patients
Emory Medical Care Foundation Inc CurrentSince Feb 21, 2020 Accepting new patients

Locations

80 Jesse Hill Jr Dr SE
Atlanta, GA 30303
Phone (404) 616-4370

1365 Clifton Rd NE
Atlanta, GA 30322
Phone (404) 778-7525

101 W Ponce de Leon Ave
Decatur, GA 30030
Phone (404) 778-4889

631 Professional Dr
Ste 450
Lawrenceville, GA 30046
Phone (770) 963-8030

Interoperability endpoints

  • Direct secure messaging: wasfaw33175@direct.emory.org

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1473984000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1473984000000",
    "number": "1033667266",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3575 KROGER BLVD SUITE 116",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "300969004",
            "telephone_number": "770-923-4433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3575 KOGER BLVD STE 116",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "300967559",
            "telephone_number": "770-923-4433"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ASFAW",
        "first_name": "WOSSEN",
        "middle_name": "ADINEW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-09-16",
        "last_updated": "2016-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "1133058",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Duluth, GA

Sources for this page

Verify at the official NPI Registry.