Individual provider Active NPI

Anum Mushtaq Gaffar, PA-C

  • Physician Assistant
  • Marietta, GA
National Provider Identifier
1326657560
Registry record updated Jul 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
9861 Issued in GA
Practice address
55 Whitcher St NE Ste 250
Marietta, GA 30060-1169
Phone
(770) 428-4475
NPI assigned
Jul 23, 2020
Last updated
Jul 15, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 9861 GA Primary
Family Medicine Physician 207Q00000X 9861 GA

Addresses

Primary practice location

55 Whitcher St NE Ste 250
Marietta, GA 30060-1169

Mailing address

55 Whitcher St NE Ste 250
Marietta, GA 30060-1169
Phone (770) 428-4475

Other practice location 1

3660 Market St
Clarkston, GA 30021-1246
Phone (470) 355-7896

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address agaffar418075@directwellstar.org

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
I20210512001893 GA Practitioner - Physician Assistant 5890104319 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wellstar Medical Group LLCGroup PAC ID 6709065402, 3,059 clinicians

Practice addresses (Care Compare)

144 Bill Carruth Pkwy
Hiram, GA 30141-3819

2518 Jimmy Lee Smith Pkwy
Hiram, GA 30141-2068
Phone (770) 732-4022

3747 Roswell Rd
Marietta, GA 30062-6227

4900 Ivey Rd NW
Acworth, GA 30101-4112

5150 Stilesboro N W Rd
Suite 220
Kennesaw, GA 30152-7742
Phone (770) 424-8222

55 Whitcher Nest
Marietta, GA 30060-1169
Phone (770) 428-4475

55 Whitcher St
Suite 260
Marietta, GA 30060-1169
Phone (943) 202-7050

625 Church Nest
Marietta, GA 30060-1101
Phone (770) 422-2004

677 Church Nest
Marietta, GA 30060-1101

677 Church St NE
Suite 100P
Marietta, GA 30060-1101
Phone (470) 793-8585

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.93 of 100Reported as apm
Quality
82.14
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Wellstar Medical Group, LLC CurrentSince May 1, 2021 Accepting new patients
Wellstar Medical Group, LLC CurrentSince May 1, 2021 Accepting new patients
Wellstar Cardiovascular Medicine, LLC Past Accepting new patients

Locations

5150 Stilesboro Rd NW
Ste 220
Kennesaw, GA 30152
Phone (770) 424-8222

55 Whitcher St NE
Ste 250
Marietta, GA 30060
Phone (770) 428-3995

805 Sandy Plains Rd
Marietta, GA 30066
Phone (770) 792-1616

Interoperability endpoints

  • Direct secure messaging: agaffar418075@directwellstar.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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1595462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626307200000",
    "number": "1326657560",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 WHITCHER ST NE STE 250",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300601169",
            "telephone_number": "770-428-4475"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 WHITCHER ST NE STE 250",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300601169",
            "telephone_number": "770-428-4475"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3660 Market St",
            "address_purpose": "LOCATION",
            "city": "Clarkston",
            "state": "GA",
            "postal_code": "300211246",
            "country_code": "US",
            "telephone_number": "470-355-7896",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GAFFAR",
        "first_name": "ANUM",
        "middle_name": "MUSHTAQ",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-23",
        "last_updated": "2021-07-15",
        "certification_date": "2021-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "9861",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "9861",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "agaffar418075@directwellstar.org",
            "affiliation": "N",
            "address_1": "55 Whitcher St NE Ste 250",
            "city": "Marietta",
            "state": "GA",
            "country_code": "US",
            "postal_code": "300601169",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Marietta, GA

Sources for this page

Verify at the official NPI Registry.