Individual provider Active NPI

Augustine Avinash Emmanuel, CRNA

  • Certified Registered Nurse Anesthetist
  • Atlanta, GA
National Provider Identifier
1043555667
Registry record updated Feb 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
RN277898 Issued in GA
Practice address
80 Jesse Hill Jr Dr SE
Atlanta, GA 30303-3031
Phone
(404) 616-1000
NPI assigned
Dec 7, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 15, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 655493 NY
Registered Nurse 163W00000X 4704279653 MI
Certified Registered Nurse Anesthetist 367500000X R215730 MD
Certified Registered Nurse Anesthetist 367500000X RN277898 GA Primary

Addresses

Primary practice location

80 Jesse Hill Jr Dr SE
Atlanta, GA 30303-3031

Mailing address

2677 Kenwood Dr
Duluth, GA 30096-3657
Phone (586) 943-5972

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, GA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20150828000389 MD Practitioner - Certified Registered Nurse Anesthetist (Crna) 2163738634 Reassigns benefits to 1 organization
I20181008003520 GA Practitioner - Certified Registered Nurse Anesthetist (Crna) 2163738634 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

80 Jesse Hill Jr Dr SE
Atlanta, GA 30303-3050
Phone (404) 616-8880

Hospital & facility affiliations

  • Grady Memorial Hospital Hospital, Atlanta, GA, CCN 110079

Merit-based Incentive Payment System (MIPS)

Final score
96.48 of 100Reported as group
Quality
87.56
Promoting interoperability
100
Improvement activities
40
Cost
75.14

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
4704279653MIMDRegistered Nurse
655493NYMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Anesthesia Consultants of Savannah, PC CurrentSince Jul 9, 2018 Accepting new patients
Johns Hopkins University Current Accepting new patients
Grady Memorial Hospital Corporation CurrentSince Sep 1, 2019 Accepting new patients
Johns Hopkins University CurrentSince Aug 3, 2015 Accepting new patients
Grady Memorial Hospital Corporation CurrentSince Sep 1, 2019 Accepting new patients
Johns Hopkins University CurrentSince Aug 3, 2015 Accepting new patients

Locations

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

4700 Waters Ave
Savannah, GA 31404
Phone (912) 273-1100

600 N Wolfe St
Baltimore, MD 21287

Organizations & group practices 6

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1354838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707955200000",
    "number": "1043555667",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2677 KENWOOD DR",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "300963657",
            "telephone_number": "586-943-5972"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "80 JESSE HILL JR DR SE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303033031",
            "telephone_number": "404-616-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EMMANUEL",
        "first_name": "AUGUSTINE",
        "middle_name": "AVINASH",
        "name_prefix": "Dr.",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-12-07",
        "last_updated": "2024-02-15",
        "certification_date": "2024-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "655493",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MI",
            "license": "4704279653",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MD",
            "license": "R215730",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "GA",
            "license": "RN277898",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.