Individual provider Active NPI

Nega Woldehawariat, M.D.

  • Nephrology Physician
  • Austell, GA
National Provider Identifier
1437210358
Registry record updated Jan 13, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
C051570 Issued in GA
Practice address
1668 Mulkey Rd
Ste G
Austell, GA 30106-1143
Phone
(770) 944-8494
Fax
(678) 945-7401
NPI assigned
Dec 13, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 13, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X C051570 GA Primary

Addresses

Primary practice location

1668 Mulkey Rd
Ste G
Austell, GA 30106-1143

Mailing address

1668 Mulkey Rd
Suite G
Austell, GA 30106-1143
Phone (770) 944-8494

Other identifiers 1

IdentifierTypeStateIssuer
000977347( I )MedicaidGA

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
I20040805000937 GA Practitioner - NephrologyPractitioner - Internal Medicine 3072593177 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
NephrologyAlso: Internal Medicine
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

6025 Professional Pkwy
Suite 101
Douglasville, GA 30134-5610
Phone (770) 944-8494

Hospital & facility affiliations

  • USRC Georgia Home Therapies Dialysis facility, Canton, GA, CCN 112890
  • Fresenius Medical Care South Cobb Dialysis facility, Austell, GA, CCN 112668
  • DaVita Douglasville Dialysis Dialysis facility, Douglasville, GA, CCN 112526
  • Fresenius Kidney Care Chapel Hill Dialysis facility, Douglasville, GA, CCN 112879
  • Wellstar Douglas Medical Center Hospital, Douglasville, GA, CCN 110184
  • Wellstar Cobb Medical Center Hospital, Austell, GA, CCN 110143

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
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
C051570GAMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Peachland Nephrology & Hypertension,PC Nephrology CurrentSince Jan 1, 2004 Accepting new patients

Locations

1668 Mulkey Rd
Ste G
Austell, GA 30106
Phone (404) 585-4964

6025 Professional Pkwy
Ste 101
Douglasville, GA 30134
Phone (770) 489-4978

575 Professional Dr
Ste 300
Lawrenceville, GA 30046
Phone (404) 275-5119

6300 Powers Ferry Rd
Ste 600
Sandy Springs, GA 30339
Phone (404) 769-2216

Interoperability endpoints

  • Direct secure messaging: nwoldehawariat32172@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 and National Provider Directory roles.

Hospital & facility affiliations 6

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": "1165968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1452643200000",
    "number": "1437210358",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1668 MULKEY RD",
            "address_2": "SUITE G",
            "city": "AUSTELL",
            "state": "GA",
            "postal_code": "301061143",
            "telephone_number": "770-944-8494",
            "fax_number": "678-945-7401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1668 MULKEY RD",
            "address_2": "STE G",
            "city": "AUSTELL",
            "state": "GA",
            "postal_code": "301061143",
            "telephone_number": "770-944-8494",
            "fax_number": "678-945-7401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOLDEHAWARIAT",
        "first_name": "NEGA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-13",
        "last_updated": "2016-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "GA",
            "license": "C051570",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000977347( I )",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Austell, GA

Sources for this page

Verify at the official NPI Registry.