Individual provider Active NPI

Wayne Emineth, P.A.-C.

  • Medical Physician Assistant
  • Alpharetta, GA
National Provider Identifier
1306804018
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
4308 Issued in GA
Practice address
401 S Main St Ste A2
Alpharetta, GA 30009-1957
Phone
(404) 816-7900
Fax
(404) 816-7929
NPI assigned
May 2, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 4308 GA Primary

Addresses

Primary practice location

401 S Main St Ste A2
Alpharetta, GA 30009-1957

Mailing address

PO Box 52226
Atlanta, GA 30355-0226
Phone (404) 816-7900

Other identifiers 1

IdentifierTypeStateIssuer
003153940AMedicaidGA

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
I20150121001987 GA Practitioner - Physician Assistant 4880918838 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Georgia Dermatology Specialists PCGroup PAC ID 6800784281, 14 clinicians

Practice addresses (Care Compare)

20 Mansell CT E
Suite 200
Roswell, GA 30076-4814
Phone (404) 355-5484

3379 Peachtree Rd NE
Suite 500
Atlanta, GA 30326-1418
Phone (404) 355-5484

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
100
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
004308GAMDPsychiatry Physician

Interoperability endpoints

  • Direct secure messaging: wemineth@olanskydermatology.emadirect.md

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1146528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1306804018",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 52226",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303550226",
            "telephone_number": "404-816-7900",
            "fax_number": "404-816-7929"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 S MAIN ST STE A2",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "300091957",
            "telephone_number": "404-816-7900",
            "fax_number": "404-816-7929"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EMINETH",
        "first_name": "WAYNE",
        "name_prefix": "Mr.",
        "credential": "P.A.-C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-02",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "GA",
            "license": "4308",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003153940A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Alpharetta, GA

Sources for this page

Verify at the official NPI Registry.