Fitsum Woldesellassie

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

License

100672 Issued in GA

Practice address

900 Towne Lake Pkwy Ste 308
Woodstock, GA 30189-1604

Phone

(414) 805-3310

NPI assigned

Mar 29, 2017

Last updated

Jun 27, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WI, GA2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Specialty

Gastroenterology

Education

Medical College of Georgia School of Medicine, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Aga, LLCGroup PAC ID 2365431350, 138 clinicians

Aga Professional Services LLCGroup PAC ID 3870768997, 175 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Northside Hospital Cherokee Hospital, Canton, GA, CCN 110008
• Northside Hospital Hospital, Atlanta, GA, CCN 110161
• Union General Hospital Hospital, Blairsville, GA, CCN 110051

Merit-based Incentive Payment System (MIPS)

Final score

87.99 of 100Reported as group

Quality

82.81

Promoting interoperability

100

Improvement activities

40

Cost

77.15

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

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: fitsum.woldesellassie@ud.eclinicaldirectplus.com
• Direct secure messaging: fwoldesellassie631655@direct.froedtert.com
• FHIR API: https://fhir-myrecord.cerner.com/r4/d88010de-d791-42d4-b72d-513f9afc5ed1/

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Aga Professional Services, LLC

  • Gastroenterology Physician
  • Atlanta, GA
  • NPI 1063799120
  Medicare reassignment Care Compare group NPD
• Aga, LLC

  dba Atlanta Gastroenterology Associates

  • Gastroenterology Physician
  • Atlanta, GA
  • NPI 1124064118
  Medicare reassignment Care Compare group NPD
• The Medical College of Wisconsin, Inc.

  • Internal Medicine Physician
  • Milwaukee, WI
  • NPI 1699720086
  Medicare reassignment NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Northside Hospital, Inc.

  dba Northside Hospital Cherokee

  • General Acute Care Hospital
  • Canton, GA
  • NPI 1225050396
  Care Compare affiliation
• Northside Hospital, Inc.

  dba Northside Hospital

  • General Acute Care Hospital
  • Atlanta, GA
  • NPI 1457396079
  Care Compare affiliation
• Union County Hospital Authority

  dba Union General Hospital

  • General Acute Care Hospital
  • Blairsville, GA
  • NPI 1487684122
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1490745600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719446400000",
    "number": "1194257279",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 TOWNE LAKE PKWY STE 308",
            "city": "WOODSTOCK",
            "state": "GA",
            "postal_code": "301891604"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 TOWNE LAKE PKWY STE 308",
            "city": "WOODSTOCK",
            "state": "GA",
            "postal_code": "301891604",
            "telephone_number": "414-805-3310"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOLDESELLASSIE",
        "first_name": "FITSUM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-03-29",
        "last_updated": "2024-06-27",
        "certification_date": "2024-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "GA",
            "license": "100672",
            "primary": true
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "WI",
            "license": "8176020",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1194257279",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Emilie Windham, PT
• David Winograd, PH.D.
• Brianna Wiseman, LPC
• Elizabeth Snelling Withers
• Adria Wofford, PT, DPT
• Nicole Marie Wolf, LPC
• Grant Collins Wolfe, M.D.
• Kelly R Wolfe
• Margaret Wolfe
• Ilya Wolfson, MD

• Gastroenterology Physician in Woodstock, GA
• Providers in Woodstock, GA by specialty
• Gastroenterology Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.