Ava Tompkins Radakovich, PA-C
Individual provider Active NPI Physician Assistant · Atlanta, GA
NPI 1043799398 · NPPES record last updated May 20, 2024
Key facts
- NPI
- 1043799398
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- 8892 (GA)
- Practice address
- 2001 Peachtree Rd NE Ste 645
Atlanta, GA 30309-1476 - Phone
- (404) 605-2050
- NPI assigned
- Aug 8, 2018
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 6
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- University of North Texas HSC, College of Osteopathic Med, 2018
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Wellstar Medical Group LLC
Practice addresses (Care Compare)
5150 Stilesboro N W Rd
Suite 220
Kennesaw, GA 30152-7742
Phone (770) 424-8222
61 Whitcher N E St
Suite 4120
Marietta, GA 30060-1179
Phone (770) 424-9732
61 Whitcher St NE
Suite 2100
Marietta, GA 30060-1179
Phone (770) 423-0595
625 Church Nest
Marietta, GA 30060-1101
Phone (770) 422-2004
677 Church Nest
Marietta, GA 30060-1101
677 Church St NE
Suite 100P
Marietta, GA 30060-1101
Phone (470) 793-8585
Hospital & facility affiliations
- Wellstar Kennestone Regional Medical Center
Merit-based Incentive Payment System (MIPS)
- Final score
- 93.93 of 100
- Quality
- 82.14
- Promoting interoperability
- 100
- Improvement activities
- 40
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in GA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20181119001481 | GA | Practitioner - Physician Assistant | 3971857590 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 8892 | GA | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Wellstar Medical Group, LLC | Current |
Accepting new patients | |
| Wellstar Medical Group, LLC | Current |
Accepting new patients | |
| Aylo Health, LLC | Past | Accepting new patients | |
| Aylo Health, LLC | Past | Accepting new patients |
Locations
5150 Stilesboro Rd NW
Ste 220
Kennesaw, GA 30152
Phone (770) 424-8222
61 Whitcher St NE
Ste 3110
Marietta, GA 30060
Phone (770) 422-2326
Interoperability endpoints
- atompkins413696@directwellstar.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 8892 | GA | Yes |
Addresses
Primary practice location
2001 Peachtree Rd NE Ste 645
Atlanta, GA 30309-1476
Mailing address
1240 Eagles Landing Pkwy Ste 110
Stockbridge, GA 30281-5173
Phone (770) 389-3855
Other practice location 1
1240 Eagles Landing Pkwy Ste 110
Stockbridge, GA 30281-5173
Phone (770) 389-3855
Other practice location 2
61 Whitcher St NE Ste 3110
Marietta, GA 30060-1179
Phone (770) 422-2326
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- Sandra Louise Radcliff
- Brittany Rader
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- Latoya Radford
- Radiance Counseling & Consulting P.L.
All providers in Atlanta, GA · Physician 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 May 20, 2024. 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.
- Order and Referring (CMS).
- 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.