Jeremy Kent Wu, CERTIFIED PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

12810 Issued in GA

Practice address

850 Lawrenceville Suwanee Rd Ste 101
Lawrenceville, GA 30043-5483

Phone

(770) 963-2451

Fax

(770) 962-0017

NPI assigned

Jan 24, 2020

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Enrolled in SC, GA2 enrollments

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 2

Specialty

Physician Assistant

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Georgia Urology, PAGroup PAC ID 8921094376, 99 clinicians

Urological Professional Services, LLCGroup PAC ID 9638391717, 72 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Northside Hospital Gwinnett Hospital, Lawrenceville, GA, CCN 110087
• Northside Hospital Hospital, Atlanta, GA, CCN 110161
• Northside Hospital Duluth Hospital, Duluth, GA, CCN 110252

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jwu25564@directmcleodehealth.org
• Direct secure messaging: jeremy.wu.p1@direct.gupa.nextgenshare.com

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.

• Urological Professional Services, LLC

  • Urology Physician
  • Atlanta, GA
  • NPI 1033521810
  Medicare reassignment Care Compare group NPD
• Georgia Urology PA

  • Urology Physician
  • Riverdale, GA
  • NPI 1245250646
  Medicare reassignment Care Compare group
• McLeod Physician Associates II

  • Family Medicine Physician
  • Florence, SC
  • NPI 1801990494
  Medicare reassignment
• Georgia Urology PA

  • Urology Physician
  • Atlanta, GA
  • NPI 1770821001
  NPD
• Georgia Urology, PA

  • Ambulatory Surgical Clinic/Center
  • Braselton, GA
  • NPI 1861222119
  NPD
• McLeod Physician Associates II

  • Urology Physician
  • Florence, SC
  • NPI 1649428194
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Northside Hospital, Inc.

  • General Acute Care Hospital
  • Atlanta, GA
  • NPI 1457396079
  Care Compare affiliation
• Northside Hospital, Inc.

  • General Acute Care Hospital
  • Duluth, GA
  • NPI 1790715381
  Care Compare affiliation
• Northside Hospital, Inc.

  • General Acute Care Hospital
  • Lawrenceville, GA
  • NPI 1952340994
  Care Compare affiliation

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

{
    "created_epoch": "1579824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736726400000",
    "number": "1508496845",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1930 BRANNAN RD",
            "city": "MCDONOUGH",
            "state": "GA",
            "postal_code": "302534310",
            "telephone_number": "678-284-4040",
            "fax_number": "678-284-4076"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "850 LAWRENCEVILLE SUWANEE RD STE 101",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300435483",
            "telephone_number": "770-963-2451",
            "fax_number": "770-962-0017"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WU",
        "first_name": "JEREMY",
        "middle_name": "KENT",
        "credential": "CERTIFIED PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-01-24",
        "last_updated": "2025-01-13",
        "certification_date": "2025-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "OH",
            "license": "50.006024",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "ME",
            "license": "PA2032",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "SC",
            "license": "4084",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "12810",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Madison Wright
• Pamela Farley Wright
• Sydney Walden Wright, PT, DPT
• Tammy Alisha Wright
• Andrew Wu
• Andrew David Wuebold
• Timilehin O Wusu, MD
• Angie Marie Wyatt, RN
• Carlos Mikkel Wynn, OTR/L
• Kimberly Wynn

• Physician Assistant in Lawrenceville, GA
• Providers in Lawrenceville, GA by specialty
• Physician Assistant in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.