Individual provider Active NPI

PA Ousman Sillah, MD

  • Student in an Organized Health Care Education/Training Program
  • Gainesville, GA
National Provider Identifier
1376393462
Registry record updated Mar 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
1439 Jesse Jewell Pkwy NE Ste 301
Gainesville, GA 30501-3806
Phone
(770) 219-0023
Fax
(770) 219-3270
NPI assigned
Mar 25, 2024
Last updated
Mar 25, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

1439 Jesse Jewell Pkwy NE Ste 301
Gainesville, GA 30501-3806

Mailing address

743 Spring St NE Rear 710
Gainesville, GA 30501-3899
Phone (770) 219-8730

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240710000617 GA Order and Referring Only - Internal MedicinePractitioner - Internal Medicine 6901341395

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Northeast Georgia Physicians Group Inc CurrentSince Mar 31, 2024 Accepting new patients

Locations

1439 Jesse Jewell Pkwy NE
Ste 301
Gainesville, GA 30501
Phone (770) 219-0023

743 Spring St NE
Rear
Gainesville, GA 30501
Phone (770) 219-1200

Interoperability endpoints

  • Direct secure messaging: psillah67222@direct.acumenmd.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1711324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711324800000",
    "number": "1376393462",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "743 SPRING ST NE REAR 710",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305013899",
            "telephone_number": "770-219-8730"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1439 JESSE JEWELL PKWY NE STE 301",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305013806",
            "telephone_number": "770-219-0023",
            "fax_number": "770-219-3270"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SILLAH",
        "first_name": "PA OUSMAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-03-25",
        "last_updated": "2024-03-25",
        "certification_date": "2024-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gainesville, GA

Sources for this page

Verify at the official NPI Registry.