Individual provider Active NPI

Emily Wetzel Dye

  • Physician Assistant
  • Lawrenceville, GA
National Provider Identifier
1073106332
Registry record updated Oct 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
1990 Riverside Pkwy
Lawrenceville, GA 30043-5925
Phone
(678) 306-2212
NPI assigned
Feb 18, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 6, 2023

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 Primary

Addresses

Primary practice location

1990 Riverside Pkwy
Lawrenceville, GA 30043-5925

Mailing address

1990 Riverside Pkwy
Lawrenceville, GA 30043-5925
Phone (678) 306-2212

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
I20241111000713 GA Practitioner - Physician Assistant 3577097724 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Atlanta Allergy and Otolaryngology Center, LLCGroup PAC ID 6608937172, 4 clinicians

Practice addresses (Care Compare)

1000 Hawthorne Ave
Suite O
Athens, GA 30606-2168
Phone 6786891100925

1990 Riverside Pkwy
Lawrenceville, GA 30043-5925
Phone 6786891100925

National Provider Directory

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

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/IIHJBA/Endpoint/IIHJBA
  • FHIR API: https://fhir4.healow.com/fhir/r4/IIHJBA

Organizations & group practices 1

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": "1613606400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696550400000",
    "number": "1073106332",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1990 RIVERSIDE PKWY",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300435925",
            "telephone_number": "678-306-2212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1990 RIVERSIDE PKWY",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300435925",
            "telephone_number": "678-306-2212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DYE",
        "first_name": "EMILY",
        "middle_name": "WETZEL",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-02-18",
        "last_updated": "2023-10-06",
        "certification_date": "2023-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lawrenceville, GA

Sources for this page

Verify at the official NPI Registry.