Individual provider Active NPI

Yassar Jomah Kanawati, M.D.

  • Psychiatry Physician
  • Atlanta, GA
National Provider Identifier
1396833638
Registry record updated Jan 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
049237 Issued in GA
Practice address
1720 Peachtree St NW Ste 320N
Atlanta, GA 30309-2449
Phone
(404) 249-8496
Fax
(404) 249-8499
NPI assigned
Oct 11, 2006
Last updated
Jan 25, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 049237 GA Primary
Addiction Psychiatry Physician 2084P0802X 049237 GA
Child & Adolescent Psychiatry Physician 2084P0804X 049237 GA

Addresses

Primary practice location

1720 Peachtree St NW Ste 320N
Atlanta, GA 30309-2449

Mailing address

478 Woodlawn Dr NE
Marietta, GA 30067-4022
Phone (770) 977-8954

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
I20041124000074 GA Practitioner - PsychiatryPractitioner - Addiction Medicine 3870558398 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
PsychiatryAlso: Addiction Medicine
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1720 Peachtree St NW
Suite 320N
Atlanta, GA 30309-2449
Phone (404) 249-8496

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
049237GAMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Peachtree Family Psychiatry Clinic CurrentSince Sep 1, 2014 Accepting new patients
Family Intervention Specialist's, Inc Past Accepting new patients

Locations

1720 Peachtree St NW
Ste 320
Atlanta, GA 30309
Phone (404) 249-8496

1720 Peachtree St NW
Ste 320N
Atlanta, GA 30309
Phone (404) 249-8496

Organizations & group practices 2

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": "1160524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674604800000",
    "number": "1396833638",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "478 WOODLAWN DR NE",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300674022",
            "telephone_number": "770-977-8954"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1720 PEACHTREE ST NW STE 320N",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303092449",
            "telephone_number": "404-249-8496",
            "fax_number": "404-249-8499"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KANAWATI",
        "first_name": "YASSAR",
        "middle_name": "JOMAH",
        "name_prefix": "Mrs.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-11",
        "last_updated": "2023-01-25",
        "certification_date": "2023-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "GA",
            "license": "049237",
            "primary": true
        },
        {
            "code": "2084P0802X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Addiction Psychiatry",
            "state": "GA",
            "license": "049237",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "GA",
            "license": "049237",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.