Individual provider Active NPI

Raphael Aswani Atulo, PA

  • Physician Assistant
  • Columbus, GA
National Provider Identifier
1376018689
Registry record updated Jan 16, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
009037 Issued in GA
Practice address
1831 5TH Ave
Columbus, GA 31904-8915
Phone
(706) 320-8750
Fax
(706) 320-8770
NPI assigned
Oct 12, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 009037 GA Primary

Addresses

Primary practice location

1831 5TH Ave
Columbus, GA 31904-8915

Mailing address

1019 Ruth Creek CT
Columbus, GA 31909-2328
Phone (706) 393-4758

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
I20190311001425 GA Practitioner - Physician Assistant 3779822689 Reassigns benefits to 8 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Piedmont Specialty Hospital Billing LLCGroup PAC ID 4183986490, 252 clinicians

Practice addresses (Care Compare)

1133 Eagles Landing Pkwy
Stockbridge, GA 30281-5085
Phone (678) 604-1000

1350 Walton Way
Augusta, GA 30901-2612
Phone (706) 774-5995

5126 Hospital Dr NE
Covington, GA 30014-2566
Phone (770) 786-7053

745 Poplar Rd
Newnan, GA 30265-1618
Phone (770) 400-1000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
91.62 of 100Reported as apm
Quality
83.25
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
009037GAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
The Medical Center Inc CurrentSince Jan 14, 2019 Accepting new patients
The Medical Center Inc CurrentSince Jan 14, 2019 Accepting new patients
Columbus Ambulatory Healthcare Services, Inc. CurrentSince Jan 4, 2020 Accepting new patients

Locations

1800 10th Ave
Columbus, GA 31901
Phone (706) 571-1120

1831 5th Ave
Columbus, GA 31904
Phone (706) 320-8700

710 Center St
Columbus, GA 31901
Phone (706) 571-1000

2122 Manchstr Expy
Columbus, GA 31904
Phone (706) 320-3128

Organizations & group practices 9

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": "1539302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1547596800000",
    "number": "1376018689",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1019 RUTH CREEK CT",
            "city": "COLUMBUS",
            "state": "GA",
            "postal_code": "319092328",
            "telephone_number": "706-393-4758"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1831 5TH AVE",
            "city": "COLUMBUS",
            "state": "GA",
            "postal_code": "319048915",
            "telephone_number": "706-320-8750",
            "fax_number": "706-320-8770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ATULO",
        "first_name": "RAPHAEL",
        "middle_name": "ASWANI",
        "name_prefix": "Mr.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-10-12",
        "last_updated": "2019-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "009037",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, GA

Sources for this page

Verify at the official NPI Registry.