Individual provider Active NPI

Mary Curran Dewyngaert, PA-AA

  • Anesthesiologist Assistant
  • Marietta, GA
National Provider Identifier
1104153402
Registry record updated Aug 29, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiologist AssistantTaxonomy code 367H00000X
License
PA005666 Issued in GA
Practice address
677 Church St NE
Marietta, GA 30060-1101
Phone
(770) 794-0477
Fax
(770) 794-3108
NPI assigned
Nov 6, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiologist Assistant 367H00000X PA005666 GA Primary

Addresses

Primary practice location

677 Church St NE
Marietta, GA 30060-1101

Mailing address

531 Roselane St NW
Suite 830
Marietta, GA 30060-6913
Phone (770) 794-0477

Other practice location 1

146 Bill Carruth Pkwy
Hiram, GA 30141-3749
Phone (770) 794-0477

Other practice location 2

531 Roselane St NW
Suite 830
Marietta, GA 30060-6913
Phone (770) 794-0477

Other practice location 3

8954 Hospital Dr
Douglasville, GA 30134-2272
Phone (770) 794-0477

Other practice location 4

2540 Windy Hill Rd SE
Marietta, GA 30067-8605
Phone (770) 797-0477

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20091216000457 GA Practitioner - Anesthesiology Assistant 6103966551 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology Assistant
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Emory Clinic IncGroup PAC ID 8820901408, 3,507 clinicians
Piedmont Anesthesia LLCGroup PAC ID 2163837972, 555 clinicians

Practice addresses (Care Compare)

1365 Clifton Rd NE
Atlanta, GA 30322-1013
Phone (404) 778-7525

350 Hospital Dr
Macon, GA 31217-3838
Phone (478) 746-7577

Hospital & facility affiliations

  • Piedmont Newnan Hospital, Inc Hospital, Newnan, GA, CCN 110229

Merit-based Incentive Payment System (MIPS)

Final score
94.51 of 100Reported as apm
Quality
80.61
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
The Emory Clinic Inc CurrentSince Jan 14, 2019 Accepting new patients
Piedmont Anesthesia Associates, L.L.C CurrentSince Oct 18, 2021 Accepting new patients
Concordia Anesthesiology, Inc CurrentSince Jun 1, 2023 Accepting new patients
Northlake Anesthesia Professionals, LLC CurrentSince Oct 5, 2009 Accepting new patients
Piedmont Anesthesia LLC CurrentSince Aug 11, 2025 Accepting new patients

Locations

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

1984 Peachtree Rd NW
Ste 515
Atlanta, GA 30309
Phone (404) 351-1754

350 Hospital Dr
Macon, GA 31217
Phone (478) 751-0367

745 Poplar Rd
Newnan, GA 30265
Phone (404) 478-8785

11650 Alpharetta Hwy
Roswell, GA 30076
Phone (770) 543-8132

1133 Eagles Landing Pkwy
Stockbridge, GA 30281
Phone (678) 604-1000

1491 Montreal Rd
Tucker, GA 30084
Phone (770) 270-1284

Organizations & group practices 5

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": "1257465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1567036800000",
    "number": "1104153402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "531 ROSELANE ST NW",
            "address_2": "SUITE 830",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300606913",
            "telephone_number": "770-794-0477",
            "fax_number": "770-794-3108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "677 CHURCH ST NE",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300601101",
            "telephone_number": "770-794-0477",
            "fax_number": "770-794-3108"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "146 Bill Carruth Pkwy",
            "address_purpose": "LOCATION",
            "city": "Hiram",
            "state": "GA",
            "postal_code": "301413749",
            "country_code": "US",
            "telephone_number": "770-794-0477",
            "fax_number": "770-794-3108",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "531 Roselane St NW",
            "address_2": "Suite 830",
            "address_purpose": "LOCATION",
            "city": "Marietta",
            "state": "GA",
            "postal_code": "300606913",
            "country_code": "US",
            "telephone_number": "770-794-0477",
            "fax_number": "770-794-3108",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8954 Hospital Dr",
            "address_purpose": "LOCATION",
            "city": "Douglasville",
            "state": "GA",
            "postal_code": "301342272",
            "country_code": "US",
            "telephone_number": "770-794-0477",
            "fax_number": "770-794-3108",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2540 Windy Hill Rd SE",
            "address_purpose": "LOCATION",
            "city": "Marietta",
            "state": "GA",
            "postal_code": "300678605",
            "country_code": "US",
            "telephone_number": "770-797-0477",
            "fax_number": "770-797-3108",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DEWYNGAERT",
        "first_name": "MARY",
        "middle_name": "CURRAN",
        "credential": "PA-AA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-11-06",
        "last_updated": "2019-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367H00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiologist Assistant",
            "state": "GA",
            "license": "PA005666",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marietta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2019; 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.