Individual provider Active NPI

Samuel Gebreyonas, NP

  • Acute Care Clinical Nurse Specialist
  • Atlanta, GA
National Provider Identifier
1285919985
Registry record updated Dec 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Clinical Nurse SpecialistTaxonomy code 364SA2100X
License
RN194592 Issued in GA
Practice address
1365 Clifton Rd NE
Ccu
Atlanta, GA 30322-1013
Phone
(404) 778-3914
NPI assigned
Oct 13, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 30, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 194592 GA
Acute Care Clinical Nurse Specialist 364SA2100X RN194592 GA Primary

Addresses

Primary practice location

1365 Clifton Rd NE
Ccu
Atlanta, GA 30322-1013

Mailing address

3173 Windfield Cir
Tucker, GA 30084-6719
Phone (516) 220-1553

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
I20120201000857 GA Practitioner - Nurse Practitioner 8820255979 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
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

2201 Henderson Mill Rd NE
Atlanta, GA 30345-2711

Hospital & facility affiliations

  • Emory University Hospital Hospital, Atlanta, GA, CCN 110010
  • Emory Decatur Hospital Hospital, Decatur, GA, CCN 110076

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
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
194592GAMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
The Emory Clinic Inc CurrentSince Dec 25, 2011 Accepting new patients
City of Hope Medical Group of Georgia LLC CurrentSince Sep 19, 2016 Accepting new patients
Grady Memorial Hospital Corporation CurrentSince Mar 3, 2024 Accepting new patients
Grady Memorial Hospital Corporation CurrentSince Mar 3, 2024 Accepting new patients

Locations

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

1365 Clifton Rd NE
Ofc A4330
Atlanta, GA 30322
Phone (404) 778-6382

80 Jesse Hill Jr Dr SE
Atlanta, GA 30303
Phone (404) 616-4370

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

600 Celebrate Life Pkwy
Newnan, GA 30265
Phone (404) 844-8334

62742 Collections Ctr Dr
Chicago, IL 60693

Interoperability endpoints

  • Direct secure messaging: sgebreyonas39581@direct.emory.org

Organizations & group practices 4

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 3

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": "1318464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1767052800000",
    "number": "1285919985",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3173 WINDFIELD CIR",
            "city": "TUCKER",
            "state": "GA",
            "postal_code": "300846719",
            "telephone_number": "516-220-1553"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1365 CLIFTON RD NE",
            "address_2": "CCU",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303221013",
            "telephone_number": "404-778-3914"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GEBREYONAS",
        "first_name": "SAMUEL",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-10-13",
        "last_updated": "2025-12-30",
        "certification_date": "2025-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "GA",
            "license": "194592",
            "primary": false
        },
        {
            "code": "364SA2100X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Acute Care",
            "state": "GA",
            "license": "RN194592",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.