Individual provider Active NPI

Ana Maria Cuebas, M.D

  • Psychiatry Physician
  • Fayetteville, GA
National Provider Identifier
1417277997
Registry record updated Nov 17, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
72866 Issued in GA
Practice address
715 Bradley Dr
Fayetteville, GA 30214-2030
Phone
(770) 358-5252
NPI assigned
Jun 7, 2010
Last updated
Nov 17, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 72866 GA Primary

Addresses

Primary practice location

715 Bradley Dr
Fayetteville, GA 30214-2030

Mailing address

PO Box 1621
Fayetteville, GA 30214-6503

Other names 1

  • Dr. Ana Maria Restrepo Botero Former name

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
I20150324002122 GA Practitioner - Psychiatry 9335466754 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1209 Greenbelt Dr
Griffin, GA 30224-4507
Phone (770) 358-5252

139 Henry Pkwy
McDonough, GA 30253-6636
Phone (770) 898-7403

715 Bradley Dr
Fayetteville, GA 30214-2030
Phone (770) 358-8622

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
72866GAMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
McIntosh Trail Community Service Board CurrentSince Dec 1, 2014 Accepting new patients
McIntosh Trail Community Service Board CurrentSince Dec 1, 2014 Accepting new patients
McIntosh Trail Community Service Board Past Accepting new patients

Locations

715 Bradley Dr
Fayetteville, GA 30214
Phone (770) 358-8622

1209 Greenbelt Dr
Griffin, GA 30224
Phone (770) 358-8250

1435 N Expressway
Ste 301
Griffin, GA 30223
Phone (678) 516-5179

1501 Kalamazoo Dr
Ste A
Griffin, GA 30224
Phone (770) 358-8250

Organizations & group practices 3

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": "1275868800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1416182400000",
    "number": "1417277997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1621",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302146503"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "715 BRADLEY DR",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302142030",
            "telephone_number": "770-358-5252"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CUEBAS",
        "first_name": "ANA",
        "middle_name": "MARIA",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-07",
        "last_updated": "2014-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "GA",
            "license": "72866",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANA",
            "last_name": "RESTREPO BOTERO",
            "middle_name": "MARIA",
            "prefix": "DR.",
            "credential": "M.D",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Fayetteville, GA

Sources for this page

Verify at the official NPI Registry.