Individual provider Active NPI

Tamiko Lin D'Elena, PA-C

  • Physician Assistant
  • Johns Creek, GA
National Provider Identifier
1164503108
Registry record updated Dec 3, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
004550 Issued in GA
Practice address
6300 Hospital Pkwy
Ste 450
Johns Creek, GA 30097
Phone
(770) 227-2222
Fax
(770) 227-2220
NPI assigned
Oct 18, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X 1601000462 MI
Physician Assistant 363A00000X 004550 GA Primary

Addresses

Primary practice location

6300 Hospital Pkwy
Ste 450
Johns Creek, GA 30097

Mailing address

6300 Hospital Pkwy
Suite 450
Johns Creek, GA 30097
Phone (770) 227-2222

Other names 1

  • Tamiko L Kolkjen Former name

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
I20090508000016 GA Practitioner - Physician Assistant 5092863621 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Wayne State University School of Medicine, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Aga Professional Services LLCGroup PAC ID 3870768997, 175 clinicians

Practice addresses (Care Compare)

1200 Northside Forsyth Dr
Cumming, GA 30041-7659
Phone (770) 844-3200

488 Kennesaw Ave NW
Suite 200
Marietta, GA 30060-9409
Phone (770) 427-3075

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
74.39 of 100Reported as group
Quality
44.91
Promoting interoperability
98
Improvement activities
40
Cost
71.38

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1601000462MIMDAudiologist

Interoperability endpoints

  • Direct secure messaging: tamiko.delena@ud.eclinicaldirectplus.com

Organizations & group practices 2

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 2

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": "1161129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1417564800000",
    "number": "1164503108",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6300 HOSPITAL PKWY",
            "address_2": "SUITE 450",
            "city": "JOHNS CREEK",
            "state": "GA",
            "postal_code": "30097",
            "telephone_number": "770-227-2222",
            "fax_number": "770-227-2220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6300 HOSPITAL PKWY",
            "address_2": "STE 450",
            "city": "JOHNS CREEK",
            "state": "GA",
            "postal_code": "30097",
            "telephone_number": "770-227-2222",
            "fax_number": "770-227-2220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "D'ELENA",
        "first_name": "TAMIKO",
        "middle_name": "LIN",
        "name_prefix": "Prof.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-18",
        "last_updated": "2014-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "MI",
            "license": "1601000462",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "004550",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TAMIKO",
            "last_name": "KOLKJEN",
            "middle_name": "L",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Johns Creek, GA

Sources for this page

Verify at the official NPI Registry.