NPIMap

Individual provider Active NPI

Avanthika Thanushi Wynn, M.D.

  • Pulmonary Disease Physician
  • Atlanta, GA
National Provider Identifier
1124306006
Registry record updated Jun 10, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
79142 Issued in GA
Practice address
5665 Peachtree Dunwoody Rd
Atlanta, GA 30342-1764
Phone
(678) 843-6497
NPI assigned
Jul 27, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2019

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist Physician 208M00000X 275177 NY
Internal Medicine Physician 207R00000X 275177 NY
Pulmonary Disease Physician 207RP1001X 79142 GA Primary

Addresses

Primary practice location

5665 Peachtree Dunwoody Rd
Atlanta, GA 30342-1764

Mailing address

5665 Peachtree Dunwoody Rd
Atlanta, GA 30342-1764
Phone (678) 843-6497

Other practice location 1

1425 Portland Ave
Rochester, NY 14621-3001
Phone (585) 922-5067

Other identifiers 3

IdentifierTypeStateIssuer
03007063/NWKMedicaidNY
03007072/OPDMedicaidNY
01131126/RGHMedicaidNY

Other names 1

  • Dr. Avanthika Thanushi Weerasinghe Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190731000224 GA Practitioner - Pulmonary Disease 7315162161 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pulmonary Disease
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
The Emory Clinic IncGroup PAC ID 8820901408, 3,507 clinicians

Practice addresses (Care Compare)

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

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
79142GAMDPulmonary Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Crisp Regional Hospital Inc Internal Medicine CurrentSince Apr 30, 2021 Accepting new patients
Crisp Regional Hospital, Inc CurrentSince Apr 30, 2021 Accepting new patients
The Emory Clinic Inc Internal Medicine CurrentSince Jul 22, 2019 Accepting new patients
Emory Health Care Past Accepting new patients
Saint Josephs Hospital of Atlanta Inc Past Accepting new patients
Hospital Authority of the City of Bainbridge and Decatur County Past Accepting new patients

Locations

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

902 N 7th St
Cordele, GA 31015
Phone (229) 276-3100

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

Interoperability endpoints

  • Direct secure messaging: awynn58341@direct.emory.org

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 6

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": "1311724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560124800000",
    "number": "1124306006",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5665 PEACHTREE DUNWOODY RD",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303421764",
            "telephone_number": "678-843-6497"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5665 PEACHTREE DUNWOODY RD",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303421764",
            "telephone_number": "678-843-6497"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1425 Portland Ave",
            "address_purpose": "LOCATION",
            "city": "Rochester",
            "state": "NY",
            "postal_code": "146213001",
            "country_code": "US",
            "telephone_number": "585-922-5067",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WYNN",
        "first_name": "AVANTHIKA",
        "middle_name": "THANUSHI",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-07-27",
        "last_updated": "2019-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "NY",
            "license": "275177",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "275177",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "GA",
            "license": "79142",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03007063/NWK",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03007072/OPD",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01131126/RGH",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AVANTHIKA",
            "last_name": "WEERASINGHE",
            "middle_name": "THANUSHI",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.